{"uin":"ICIHLIP25045V012425","name":"Health Shield Inclusive_ICIHLIP25045V012425","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425","insurer":{"slug":"icici-lombard-general-insurance","name":"ICICI LOMBARD General Insurance Company Limited","url":"https://indiainsurances.com/insurer/icici-lombard-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Health Shield Inclusive is a health indemnity policy offered on Individual Plan and Individual Combo Plan with a one year policy period and sum insured from ₹ 5,00,000 to ₹ 10,00,000. It has a 30 day initial waiting period, 36 month PED waiting period, 24 month specific disease waiting period, room rent limit of 1% of sum insured per day and ICU limit of 2% of sum insured per day.","analysis":{"state":"machine","analysed_at":"2026-10-20 04:26:47.617758+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Individual Plan","Individual Combo Plan"],"display":"Individual Plan; Individual Combo Plan","note":null,"quote":"In given product Individual Plan and Individual Combo Plan is offered, therefore it shows premium illustration of Individual Plan and Individual Combo only.","sources":[{"clause":"Annexure A","heading":null,"page":16,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20268#c-annexure-a"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"One policy period is one year.","display":"Policy period of one year","note":null,"quote":"• Policy tenure: You can opt for a Policy with Policy period of one year.","sources":[{"clause":"Section 2","heading":"Salient features and Benefits","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20268#c-section-2"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For cashless treatment, pre-authorisation must be requested at least 48 hours before a planned hospitalisation and within 24 hours of emergency hospitalisation. For reimbursement, notice with particulars must be given immediately.","display":"Cashless: 48 hours before planned hospitalisation and within 24 hours of emergency hospitalisation; reimbursement: immediately","note":null,"quote":"You must request pre-authorisation at least 48 hours before a planned Hospitalisation and in case of an emergency situation, within 24 hours of Hospitalisation. ... The above information needs to be provided to Us or Our In house claim processing team immediately.","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":40,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-40"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Duly completed Claim form signed by You and the Medical Practitioner","Original bills, receipts and discharge certificate/card from the Hospital/Medical Practitioner","Original bills from chemists supported by proper prescription","Original investigation test reports and payment receipts","Indoor case papers","Medical Practitioner’s referral letter advising Hospitalisation in non-Accident cases","Any other document as required by Us or Our In house claim processing team to investigate the Claim or Our obligation to make payment for it"],"display":"Claim form, original hospital bills/receipts/discharge certificate, chemist bills with prescription, investigation reports and receipts, indoor case papers, referral letter for non-accident hospitalisation, and any other required document","note":null,"quote":"a) Duly completed Claim form signed by You and the Medical Practitioner. The claim form can be downloaded from Our website www.icicilombard.com\nb) Original bills, receipts and discharge certificate/card from the Hospital/Medical Practitioner\nc) Original bills from chemists supported by proper prescription.\nd) Original investigation test reports and payment receipts.\ne) Indoor case papers\nf) Medical Practitioner’s referral letter advising Hospitalisation in non-Accident cases.\ng) Any other document as required by Us or Our In house claim processing team to investigate the Claim or Our obligation to make payment for it","sources":[{"clause":"2","heading":"CLAIM DOCUMENTS","page":43,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-2-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"Reimbursement claims are processed within 15 days of receipt of the claim along with claim form and documents. For cashless claims, the insurer responds to pre-authorisation within 1 hour of receipt and grants final authorisation within three hours of the discharge authorisation request.","display":"Reimbursement: within 15 days of receipt of claim, claim form and documents; cashless: pre-authorisation response within 1 hour and final authorisation within three hours of discharge authorisation request","note":null,"quote":"If You notify pre-authorization request for cashless facility through any of Our empaneled network hospitals along with complete set of documents & information, We will respond within 1 hour of the actual receipt of such pre-authorization request. Further, we shall grant final authorization within three hours of the receipt of discharge authorization request from the hospital ... The claim will be processed within 15 days of receipt of the claim along with claim form and documents.","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":40,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-40"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":42,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-42"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Pre-Existing Diseases: expenses related to PED and direct complications excluded until 36 months","Specified Disease/Procedure waiting period: listed conditions, surgeries/treatments excluded until 24 months","30-day waiting period for any illness except accident claims","Investigation & Evaluation","Rest Cure, rehabilitation and respite care","Obesity/ Weight Control expenses that do not fulfil conditions","Cosmetic or plastic Surgery","Breach of law","Excluded Providers","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof","Treatments received in heath hydros, nature cure clinics, spas or similar establishments","Unproven Treatments","Maternity","Personal comfort, cosmetics, convenience and hygiene related items and services","Intentional self-injury"],"display":"PED for 36 months; specified diseases/procedures for 24 months; 30-day illness waiting period; investigation/evaluation; rest cure/rehabilitation/respite care; obesity/weight control outside conditions; cosmetic or plastic surgery; breach of law; excluded providers; alcoholism/drug/substance abuse; health hydros/nature cure/spas; unproven treatments; maternity; personal comfort items; intentional self-injury","note":null,"quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer. ... Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. ... Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. ... Code- Excl04: Investigation & Evaluation ... Code- Excl05: Exclusion Name: Rest Cure, rehabilitation and respite care ... Code- Excl06: Obesity/ Weight Control Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions: ... Code- Excl08: Cosmetic or plastic Surgery Expenses for cosmetic or plastic surgery ... Code- Excl10: Breach of law Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent. ... Code- Excl11: Excluded Providers ... Code- Excl12: Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Code- Excl13: Treatments received in heath hydros, nature cure clinics, spas or similar establishments ... Code- Excl16: Unproven Treatments: Expenses related to any unproven treatment ... Code- Excl18: Maternity: ... c) Personal comfort, cosmetics, convenience and hygiene related items and services ... f) Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)","sources":[{"clause":"Excl01","heading":"Code- Excl01: Pre-Existing Diseases","page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl01"},{"clause":"Excl02(a)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl02-a"},{"clause":"Excl03","heading":"Code- Excl03: 30-day waiting period","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl03"},{"clause":null,"heading":"5. Permanent Exclusions","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-5-permanent-exclusions"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-24"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":25,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-25"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":26,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-26"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"First contact ICICI Lombard through its website, toll free number, email or the listed Mumbai address, or approach the grievance cell at a company branch. If not satisfied, contact the grievance redressal officer before escalating to IRDAI or the Insurance Ombudsman.","display":"Contact ICICI Lombard by website, 1800 2666, customersupport@icicilombard.com or branch grievance cell; then grievance redressal officer","note":null,"quote":"In case of any grievance the insured person may contact the Company through Website: www.icicilombard.com Toll free: 1800 2666 Email: customersupport@icicilombard.com ICICI Lombard General Insurance Co. Ltd. Ground floor- Interface 11, Sixth floor- Interface 16 , Office no 601 & 602, New linking Road, Malad (West), Mumbai – 400064 ... lnsured person may also approach the grievance cell at any of the company's branches with the details of grievance. ... lf lnsured person is not satisfied with the redressal of grievance ,insured person may contact the grievance redressal officer at the details provided in the below link:","sources":[{"clause":null,"heading":"Redressal of Grievances","page":31,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-redressal-of-grievances"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":31,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-31"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"Minimum Sum Insured is ₹ 5,00,000 and Maximum Sum Insured is ₹ 10,00,000.","display":"₹ 5,00,000 to ₹ 10,00,000","note":"The policy wording points to the Policy Schedule for the Sum Insured; the range is from the prospectus.","quote":"Minimum Sum Insured: ₹ 5,00,000 Maximum Sum Insured: ₹ 10,00,000","sources":[{"clause":"Section 2","heading":"Salient features and Benefits","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20268#c-section-2"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to covered accident claims.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"Excl03","heading":"Code- Excl03: 30-day waiting period","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl03"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"36 months","note":"Applies afresh to the enhanced sum insured; portability credit can reduce the period.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.","sources":[{"clause":"Excl01","heading":"Code- Excl01: Pre-Existing Diseases","page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl01"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"Hypertension, Diabetes and Cardiac Conditions have a 90 days exclusion unless pre-existing and disclosed at underwriting. Bariatric surgery cover also has a 24 months waiting period.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. ... Expenses related to the treatment of the below mentioned illness within 90 days from the first policy commencement date shall be excluded unless they are pre-existing and disclosed at the time of underwriting\ni) Hypertension ... ii) Diabetes\niii) Cardiac Conditions ... This benefit has a waiting period of 24 months from date of inception of the first policy with Us.","sources":[{"clause":"Excl02(a)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl02-a"},{"clause":"Excl02(e)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl02-e"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":23,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-23"},{"clause":null,"heading":"Conditions: -","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-conditions"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Cataract","Benign Prostatic Hypertrophy","Myomectomy, Hysterectomy unless because of malignancy","All types of Hernia, Hydrocele","Fissures &/or Fistula in anus, hemorrhoids/piles","Arthritis, gout, rheumatism and spinal disorders","Joint replacements unless due to accident","Sinusitis and related disorders","Stones in the urinary and billiary systems","Dilatation and curettage, Endometriosis","All types of Skin and internal tumors/ cysts/nodules/ polyps of any kind including breast lumps unless malignant","Dialysis required for chronic renal failure","Surgery on tonsils, adenoids and sinuses","Gastric and Duodenal erosions & ulcers","Deviated Nasal Septum","Varicose Veins/ Varicose Ulcers","Hypertension","Diabetes","Cardiac Conditions","Bariatric surgery/treatment"],"display":"Cataract; Benign Prostatic Hypertrophy; Myomectomy/Hysterectomy unless malignancy; Hernia/Hydrocele; Fissures/Fistula/hemorrhoids; Arthritis/gout/rheumatism/spinal disorders; Joint replacements unless accident; Sinusitis; urinary and billiary stones; Dilatation and curettage/Endometriosis; skin/internal tumors/cysts/nodules/polyps; Dialysis for chronic renal failure; tonsils/adenoids/sinuses surgery; Gastric and Duodenal erosions & ulcers; Deviated Nasal Septum; Varicose Veins/Ulcers; Hypertension; Diabetes; Cardiac Conditions; Bariatric surgery/treatment","note":"The first listed group has a 24 months waiting period; Hypertension, Diabetes and Cardiac Conditions have a 90 days exclusion unless pre-existing and disclosed at underwriting.","quote":"List of specific diseases/procedure:\n• Cataract*\n• Benign Prostatic Hypertrophy\n• Myomectomy, Hysterectomy unless because of malignancy\n• All types of Hernia, Hydrocele\n• Fissures &/or Fistula in anus, hemorrhoids/piles\n• Arthritis, gout, rheumatism and spinal disorders\n• Joint replacements unless due to accident\n• Sinusitis and related disorders\n• Stones in the urinary and billiary systems\n• Dilatation and curettage, Endometriosis\n• All types of Skin and internal tumors/ cysts/nodules/ polyps of any kind including breast lumps unless malignant\n• Dialysis required for chronic renal failure\n• Surgery on tonsils, adenoids and sinuses\n• Gastric and Duodenal erosions & ulcers\n• Deviated Nasal Septum\n• Varicose Veins/ Varicose Ulcers ... i) Hypertension ... ii) Diabetes\niii) Cardiac Conditions ... Bariatric surgery/treatment performed for cosmetic reasons is excluded","sources":[{"clause":"Excl02(e)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl02-e"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":23,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-23"},{"clause":null,"heading":"Conditions: -","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-conditions"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"For enhanced sum insured, sixty continuous months applies from the date of enhancement on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called as moratorium period.","sources":[{"clause":null,"heading":"11. Moratorium Period","page":30,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-11-moratorium-period"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"You may port the policy from one insurer to another and transfer credits gained to the extent of the sum insured and benefits available in the previous policy, subject to underwriting. Application must be made at least 30 days before, but not earlier than 60 days from, the renewal due date.","display":"Portability allowed with waiting-period credit; apply 30 to 60 days before renewal due date","note":"Not applicable for enhanced sum insured.","quote":"The insured has the choice to port his / her policies from one Insurer to another. An Insured desirous of porting his/her policy to another insurer shall apply to such insurer to port the entire policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from the due date for renewal.\nb) The insured is entitled to transfer the credits gained to the extent of the sum insured and the benefits available in the previous policy, subject to the underwriting policy of the Company.","sources":[{"clause":"Excl03(II)(d)(ii)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl03-ii-d-ii"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Yes, no maximum age limit for Renewal","note":null,"quote":"Lifetime renewability: There is no maximum age limit for Renewal.","sources":[{"clause":"2","heading":"Lifetime renewability","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20268#c-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"No loading applies on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"iv) No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":29,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-29"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["Code- Excl04: Investigation & Evaluation","Code- Excl05: Rest Cure, rehabilitation and respite care","Code- Excl06: Obesity/ Weight Control","Code- Excl08: Cosmetic or plastic Surgery","Code- Excl10: Breach of law","Code- Excl11: Excluded Providers","Code- Excl12: Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof","Code- Excl13: Treatments received in heath hydros, nature cure clinics, spas or similar establishments","Code- Excl14: Dietary supplements and substances that can be purchased without prescription","Code- Excl16: Unproven Treatments","Code- Excl18: Maternity","prosthesis, corrective devices, external durable medical equipment","Treatment, procedures and preventive, diagnostic, restorative, cosmetic services related to disease, disorder and conditions related to natural teeth and gingiva","Personal comfort, cosmetics, convenience and hygiene related items and services","Acupressure, acupuncture, magnetic and other therapies","Circumcision unless necessary for treatment of an Illness or necessitated due to an Accident","Intentional self-injury","war, invasion, acts of foreign enemies, hostilities","nuclear weapons/materials or ionising radiation"],"display":"Permanent exclusions include Excl04, Excl05, Excl06, Excl08, Excl10, Excl11, Excl12, Excl13, Excl14, Excl16, Excl18 and specific exclusions for external medical equipment, dental treatment, personal comfort items, acupressure/acupuncture/magnetic therapies, circumcision except illness/accident, intentional self-injury, war and nuclear/radiation events","note":null,"quote":"i) Code- Excl04: Investigation & Evaluation ... ii. Code- Excl05: Exclusion Name: Rest Cure, rehabilitation and respite care ... iii. Code- Excl06: Obesity/ Weight Control ... iv. Code- Excl08: Cosmetic or plastic Surgery ... v. Code- Excl10: Breach of law ... vi. Code- Excl11: Excluded Providers ... vii. Code- Excl12: Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.\nviii. Code- Excl13: Treatments received in heath hydros, nature cure clinics, spas or similar establishments ... ix. Code- Excl14: Dietary supplements and substances that can be purchased without prescription ... x. Code- Excl16: Unproven Treatments ... xi. Code- Excl18: Maternity: ... a) Any expenses incurred on prosthesis, corrective devices, external durable medical equipment of any kind ... b) Treatment, procedures and preventive, diagnostic, restorative, cosmetic services related to disease, disorder and conditions related to natural teeth and gingiva ... c) Personal comfort, cosmetics, convenience and hygiene related items and services\nd) Acupressure, acupuncture, magnetic and other therapies ... e) Circumcision unless necessary for treatment of an Illness or necessitated due to an Accident.\nf) Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)\ng) Any injury or illness caused by or arising from or attributed to war, invasion, acts of foreign enemies, hostilities ... h) Any Illness or Injury caused by or contributed to by nuclear weapons/materials or contributed to by or arising from ionising radiation","sources":[{"clause":null,"heading":"5. Permanent Exclusions","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-5-permanent-exclusions"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-24"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":25,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-25"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":26,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-26"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"You may cancel during the term by giving 7 days’ written notice. For terms up to one year, proportionate premium for the unexpired period is refunded if no claim was made; for policies over one year, premium for unexpired policy years is refunded where risk coverage has not commenced.","display":"7 days’ notice; proportionate refund for unexpired period if term up to one year and no claim; refund for unexpired policy years if term more than 1 year and risk has not commenced","note":"Free-look cancellations follow the Free look clause. No premium refund on cancellation for established fraud.","quote":"The insured may cancel the policy at any time during the term, by giving 7 days’ notice in writing. The company shall ... Refund proportionate premium for unexpired policy period, if the term of policy up to one year and there is no claim (s) made during the policy period. ... Refund premium for the unexpired policy period, in respect of policies with term more than 1 year and risk coverage for such policy years has not commenced.","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":28,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-28"},{"clause":"Excl03(II)(d)(i)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl03-ii-d-i"},{"clause":"Excl03(II)(d)(ii)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-excl03-ii-d-ii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"All medical treatment must be taken in India only unless the Optional Cover Worldwide Cover has been opted for.","display":"India only, unless Optional Cover Worldwide Cover is opted","note":null,"quote":"All medical treatment for the purpose of this insurance will have to be taken in India only unless Optional Cover Worldwide Cover has been opted for.","sources":[{"clause":"19","heading":"Territorial Limit","page":33,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-19"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Not available for policies with tenure of less than a year.","quote":"Every insured of new health insurance policies, except for those policies with tenure of less than a year, shall be provided a free look period of 30 days beginning from the date of receipt of policy document, whether received electronically or otherwise, to review the terms and conditions of such policy.","sources":[{"clause":"14","heading":"Free look period","page":31,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-14"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days; 15 days for monthly premium mode","note":"Monthly premium mode has fifteen days; all other cases have thirty days.","quote":"The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.","sources":[{"clause":null,"heading":"12. Premium Payment in installments","page":30,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-12-premium-payment-in-installments"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"New borns up to 17 years of age can be insured; adults from age 18 years can be insured without any maximum age limit.","display":"New Born to 17 years; adults from 18 years with no maximum age limit","note":null,"quote":"This Policy can be offered to New Born till maximum up to 17 years of age. Adults from age 18 years without any maximum age limit can be insured.","sources":[{"clause":"1","heading":"Entry age","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20268#c-1"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Annual","Half-Yearly","Quarterly","Monthly"],"display":"Annual, Half-Yearly, Quarterly, Monthly","note":null,"quote":"Policy Tenure | Loading on total premium based on Period Payment Plan\n(in years) | Annual | Half-Yearly | Quarterly | Monthly","sources":[{"clause":"Excl03(II)(k)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20268#c-excl03-ii-k"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["Worldwide Cover"],"display":"Worldwide Cover","note":null,"quote":"All medical treatment for the purpose of this insurance will have to be taken in India only unless Optional Cover Worldwide Cover has been opted for.","sources":[{"clause":"19","heading":"Territorial Limit","page":33,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-19"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is not available during the renewal grace period. If premium is paid in instalments during the policy period, coverage is offered during the grace period.","display":"No coverage during renewal grace period; coverage during instalment grace period if premium is paid in instalments during the policy period","note":null,"quote":"At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy. Coverage is not available during the grace period. ... Provided the company shall offer coverage during the grace period, if the premium is paid in instalments during the policy period.","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":29,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-29"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":30,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-30"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room rent is capped at up to a maximum of 1% of Sum Insured per day.","display":"Room Rent – Up to a maximum of 1% of SI/day","note":"The policy wording says room rent charges are up to the limits mentioned in the Policy Schedule; the CIS states the percentage cap.","quote":"Room Rent Capping: Room Charges (Hospitalization): o Room Rent – Up to a maximum of 1% of SI/day o ICU charges – Up to a maximum of 2 % of SI/day","sources":[{"clause":null,"heading":"Basic Covers","page":9,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20129#c-basic-covers"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-applicable","value":null,"display":null,"note":"This policy states the room limit as a percentage of sum insured per day, not as a room-category limit.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU charges are capped at up to a maximum of 2% of Sum Insured per day.","display":"ICU charges – Up to a maximum of 2 % of SI/day","note":"The CIS states the percentage cap.","quote":"Room Rent Capping: Room Charges (Hospitalization): o Room Rent – Up to a maximum of 1% of SI/day o ICU charges – Up to a maximum of 2 % of SI/day","sources":[{"clause":null,"heading":"Basic Covers","page":9,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20129#c-basic-covers"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"quote-verified","value":"If the insured person is admitted in a room category or limit higher than the specified limit, the insured person bears a rateable proportion of associated medical expenses in proportion to the difference between the entitled room rent and the room rent actually incurred. Proportionate deductions are not applicable for ICU charges and are not applicable for hospitals or expenses without differential billing by room category.","display":"Yes, rateable proportion of Associated medical expenses if room category/limit is higher than specified; not applicable for ICU charges","note":null,"quote":"If the Insured Person is admitted in a room category/limit that is higher than the one that is specified in the Policy Schedule/ Product benefit table of this policy, then the Insured Person shall bear a rateable proportion of the total Associated medical expenses (including surcharges or taxes thereon) in the proportion of the difference between room rent of the entitled room category to the room rent actually incurred ... b) Proportionate deductions are not applicable for ICU charges\nc) Proportionate deductions shall not be applicable for hospitals which do not follow differential billing or for those expenses in respect of which differential billing is not adopted based on the room category.","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":14,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-14"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"conflicting","value":"Zone based co-payment applies where treatment is taken in a zone higher than the zone for which premium was paid. Voluntary co-payment applies on the amount payable by the insurer if opted.","display":"Zone based Co-payment applies for treatment in a higher zone; voluntary co-payment applies if opted","note":"CIS says: “Co-payment (It is a specified amount /percentage of the admissible claim amount to be paid by policyholder/insured)\nNot Applicable”.","quote":"ii. Zone based Co-payment shall be applicable in all cases where treatment is taken in a zone higher than for which premium was paid for\niii. Voluntary Co-payment shall be applicable on the amount payable by Us and our liability to make payment shall than be arrived at.","sources":[{"clause":"I(a)(iii)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-i-a-iii"},{"clause":null,"heading":"Co-payment (It is a specified amount /percentage of the","page":9,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20129#c-co-payment-it-is-a-specified-amount-percentage-o"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"quote-verified","value":"Not Applicable.","display":"Not Applicable","note":null,"quote":"Deductible (It is a specified amount:\n- Up to which an insurance company will not pay any claim, and\n- Which will be deducted from total claim amount (if claim amount is more than the specified amount)\nNot Applicable","sources":[{"clause":null,"heading":"Co-payment (It is a specified amount /percentage of the","page":9,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20129#c-co-payment-it-is-a-specified-amount-percentage-o"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Cataract Treatment: 10% of the Annual Sum insured subject to a maximum of ₹ 50,000 per eye","Domestic Road Ambulance Cover: limited to 1% of Annual Sum Insured maximum up to ₹ 10,000","Bariatric Surgery Cover: up to 50% of Sum Insured maximum up to Rs. 1 Lakh"],"display":"Cataract: 10% of Annual Sum Insured, max ₹ 50,000 per eye; Domestic Road Ambulance: 1% of Annual Sum Insured, max ₹ 10,000; Bariatric Surgery: 50% of Sum Insured, max Rs. 1 Lakh","note":"The CIS lists these financial sub-limits.","quote":"The policy will pay only up to the limits specified hereunder for the following diseases/procedures:\n• For Cataract Treatment, a sub-limit of 10% of the Annual Sum insured subject to a maximum of ₹ 50,000 per eye is applicable ... • Domestic Road Ambulance Cover- limited to 1% of Annual Sum Insured maximum up to ₹ 10,000.\n• Bariatric Surgery Cover: up to 50% of Sum Insured maximum up to Rs. 1 Lakh.","sources":[{"clause":null,"heading":"Sub-limit (It is a pre- defined limit and the insurance","page":9,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20129#c-sub-limit-it-is-a-pre-defined-limit-and-the-insu"},{"clause":null,"heading":"Basic Covers","page":9,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20129#c-basic-covers"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Provided on reimbursement basis only.","quote":"We will cover the Pre-Hospitalization Medical Expenses incurred in respect of the Insured Person immediately before the Insured Person’s Admission to Hospital up to 30 days as specified in the Policy Schedule","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":16,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-16"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days","note":null,"quote":"We will cover the Post-Hospitalization Medical Expenses incurred in respect of the Insured Person immediately following the Insured Person’s discharge from Hospital up to 60 days as specified in the Policy Schedule","sources":[{"clause":"5","heading":"Post- Hospitalization Medical Expense","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-5"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Day care treatment is covered up to the Annual Sum Insured and requires hospitalisation as an inpatient for less than 24 hours. The cover includes procedures including but not limited to intravenous chemotherapy, radiotherapy, hemodialysis or any other therapeutic procedure requiring specialised observation or medical care.","display":"Covered for less than 24 hours; includes but not limited to intravenous chemotherapy, radiotherapy, hemodialysis and other therapeutic procedures requiring specialised observation or medical care","note":"Out Patient Treatment and diagnostic services are not covered under this benefit.","quote":"We will cover the Medical Expenses incurred in respect of the Day Care Treatment of the Insured Person during the Policy Period up to the Annual Sum Insured as specified in the Policy Schedule provided that:\ni) Day Care treatment requires hospitalization as an inpatient for less than 24 hours in a Hospital.\nii) We will also cover Medical Expenses incurred for procedures including but not limited to intravenous chemotherapy, radiotherapy, hemodialysis or any other therapeutic procedure which requires a period of specialized observation or medical care after completion of the procedure.","sources":[{"clause":"2","heading":"Day Care Procedures/Treatment","page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-2"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary Hospitalization is covered if it continues for at least 3 consecutive days, with payment from the first day, subject to listed exclusions.","display":"Covered if Domiciliary Hospitalization continues for at least 3 consecutive days","note":"Asthma, bronchitis, arthritis, spine/disc ailments, chronic nephritis, liver disease, peptic ulcer, diarrhoea/dysentery/gastroenteritis, diabetes, epilepsy, hypertension and pyrexia are excluded under this cover.","quote":"We will cover the Medical Expenses incurred in respect of the Domiciliary Hospitalization of the Insured Person during the Policy Period provided that:\ni) The Domiciliary Hospitalization continues for at least 3 consecutive days in which case we will make payment under this Cover in respect of Medical Expenses incurred from the first day of Domiciliary Hospitalization.","sources":[{"clause":"9","heading":"Domiciliary Hospitalization","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-9"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"In-patient AYUSH treatment is covered up to the Annual Sum Insured if the insured person is hospitalised for AYUSH treatment at an AYUSH Hospital or AYUSH Day Care Centre.","display":"Covered up to Annual Sum Insured at an AYUSH Hospital or AYUSH Day Care Centre","note":"Provided on reimbursement basis and/or cashless basis wherever applicable.","quote":"We will cover medical expenses incurred in respect of Insured Person’s AYUSH Treatment during the Policy Period up to the Annual Sum Insured specified in the Policy Schedule provided that –\ni) The Insured person is Hospitalised for AYUSH Treatment at a AYUSH Hospital or AYUSH Day Care Centre.","sources":[{"clause":"6","heading":"In Patient AYUSH Hospitalization","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-6"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Technological advancements and treatments are covered up to the Annual Sum Insured for the listed treatments including uterine artery embolization and HIFU, immunotherapy, Green laser or holmium laser prostate treatment, hematopoietic stem cell therapy for bone marrow transplant for haematological conditions, balloon sinuplasty, oral chemotherapy, robotic surgeries, stereotactic radio surgeries, deep brain stimulation, intra vitreal injections, bronchical thermoplasty and IONM.","display":"Covered up to Annual Sum Insured for listed technological advancements and treatments, including immunotherapy, oral chemotherapy, robotic surgeries and stem cell therapy for specified bone marrow transplant","note":null,"quote":"We will cover the Medical Expenses incurred in respect of Hospitalization of the Insured Person for the below mentioned technological advancements and treatments during the Policy Period, up to the Annual Sum Insured\nSr. No | Treatment/Procedure\n1 | Uterine Artery Embolization and HIFU (High intensity focused ultrasound)\n2 | Immunotherapy- Monoclonal Antibody to be given as injection\n3 | Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)\n4 | Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions\n5 | Balloon Sinuplasty\n6 | Oral Chemotherapy\n7 | Robotic surgeries\n8 | Stereotactic radio Surgeries\n9 | Deep Brain stimulation\n10 | Intra vitreal injections\n11 | Bronchical Thermoplasty\n12 | IONM - (Intra Operative Neuro Monitoring)","sources":[{"clause":"3","heading":"Technological Advancements and Treatments","page":16,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-3"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"Organ donor hospitalisation medical expenses for harvesting an organ donated to the insured person are covered up to the Annual Sum Insured, subject to the organ donation law, use for the insured person, in-patient donor expenses only, and acceptance of the insured person’s inpatient claim.","display":"Covered up to Annual Sum Insured for organ donor’s Hospitalization for harvesting the organ donated to the Insured Person","note":"Pre/post-hospitalisation, screening, acquisition, organ transport or preservation, and donor complications are excluded.","quote":"We will cover the medical expenses incurred in respect of an organ donor’s Hospitalization during the Policy Period for harvesting of the organ donated to the Insured Person up to the Annual Sum Insured specified in the Policy Schedule provided that:\ni) The organ donation confirms to the Transportation of Human Organs Act 1994 and the organ is used for the Insured Person\nii) We will cover only those Medical Expenses incurred in respect of an organ donor as an in-patient in the Hospital.\niii) We have accepted a claim under Section “Inpatient treatment” in respect of the Insured Person.","sources":[{"clause":"8","heading":"Donor Expenses","page":18,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-8"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Domestic road ambulance is covered for transfer to the nearest hospital with adequate emergency facilities. Reimbursement is limited to 1% of Annual Sum Insured up to Rs. 10,000 per claim in a policy year; cashless ambulance services are covered as per actuals.","display":"Road ambulance: reimbursement up to 1% of Annual Sum Insured, max Rs. 10,000; cashless as per actuals","note":"Requires accepted Inpatient Treatment claim for the same Accident/Illness.","quote":"We will cover the expenses incurred on road ambulance services which are offered by a healthcare or ambulance service provider and which have been used during the Policy Period to transfer the Insured Person to the nearest Hospital from the place of ... Accident/Illness with adequate emergency facilities for the provision of Emergency Care, provided that:\n• Our maximum liability under this Benefit for every claim arising during the Policy Year will be restricted to 1% of the Annual Sum Insured maximum up to Rs. 10,000 in case the charges of road ambulance are being reimbursed. In case the services of a health care or ambulance service provider are being availed on cashless basis, the charges of road ambulance will be covered as per actuals.","sources":[{"clause":"7","heading":"Domestic Road Ambulance","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-7"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-17"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"Consumables are covered under inpatient treatment only if they are not in the excluded non-medical expenses list. The non-payable list includes gloves, masks and other items.","display":"Consumables covered except excluded non-medical items; GLOVES and MASK are non-payable","note":null,"quote":"medicines, drugs and consumables (other than those specified in the list of excluded expenses (non-medical) in Annexure I; ... 56 | GLOVES ... 60 | MASK","sources":[{"clause":"1","heading":"Inpatient Treatment","page":14,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-1"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":35,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-35"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":36,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-36"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity treatment is excluded: childbirth expenses, including complicated deliveries and caesarean sections during hospitalisation, are excluded except ectopic pregnancy; miscarriage and lawful medical termination expenses are excluded unless due to an accident.","display":"Excluded, except ectopic pregnancy; miscarriage unless due to an accident is excluded","note":null,"quote":"xi. Code- Excl18: Maternity:\ni) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalisation) except ectopic pregnancy.\nii) Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":25,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-25"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"not-stated","value":null,"display":null,"note":"The documents define newborn and mention addition of new born baby by endorsement, but do not state a newborn baby cover from birth or its limit.","quote":null,"sources":[],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"not-stated","value":null,"display":null,"note":"The Day Care benefit excludes Out Patient Treatment under that benefit, but the documents do not state a separate OPD cover or limit.","quote":null,"sources":[],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"quote-verified","value":"Premium is computed based on the zone chosen by the insured person, and zone based co-payment applies where treatment is taken in a zone higher than the zone for which premium was paid.","display":"Premium computed basis zone chosen; zone based co-payment if treatment is in a higher zone","note":null,"quote":"Zone Based Pricing - Premium will be computed basis zone chosen by Insured Person. ... ii. Zone based Co-payment shall be applicable in all cases where treatment is taken in a zone higher than for which premium was paid for","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20129#c-icici-lombard-general-insurance-company-limited-15"},{"clause":"I(a)(iii)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-i-a-iii"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless treatment is available only at a Network Provider, where the insurer directly pays treatment costs to the network provider to the extent of approved pre-authorisation.","display":"Cashless treatment only at a Network Provider","note":null,"quote":"Cashless treatment is only available at a Network Provider (List of Network Providers is available at our website). ... \"Cashless facility\" means a facility extended by the Insurer to the Insured where, the payments of the costs of treatment undergone by the Insured in accordance with the Policy terms and conditions are directly made to the network provider by the Insurer to the extent pre-authorization approved.","sources":[{"clause":null,"heading":"1 CLAIMS PROCEDURE","page":40,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-1-claims-procedure"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims are handled by the Company or its in house claim processing team.","display":"Company or Our in house claim processing team","note":null,"quote":"You shall give notice to Us or Our In house claim processing team by calling the toll free number 1800 2666 or emailing us at customersupport@icicilombard.com","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":40,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532#c-icici-lombard-general-insurance-company-limited-40"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":false,"display":"No, policy can be availed only on individual basis","note":null,"quote":"Number of members: Policy can be availed only on individual basis.","sources":[{"clause":"3","heading":"Number of members","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20268#c-3"}],"law":[]}],"documents":[{"kind":"wording","label":"Health Shield Inclusive_ICIHLIP25045V012425","pages":47,"fetched_at":"2026-10-20 02:43:43+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/health-shield-inclusive8c0007ff45fd68ff8a0df0055fa763a7.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20532"},{"kind":"prospectus","label":"Health Shield Inclusive_ICIHLIP25045V012425","pages":16,"fetched_at":"2026-10-20 02:28:21+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/prospectus-sales-literature_health-shield-inclusive8c0007ff45fd68ff8a0df0055fa752ac.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20268"},{"kind":"prospectus","label":"Health Shield Inclusive_ICIHLIP25045V012425","pages":16,"fetched_at":"2026-10-20 02:28:33+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/prospectus-sales-literature_health-shield-inclusive8c0007ff45fd68ff8a0df0055f9f1320.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20271"},{"kind":"cis","label":"Health Shield Inclusive_ICIHLIP25045V012425","pages":17,"fetched_at":"2026-10-20 02:18:49+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/cis-health-shield-inclusive-icihlip25045v012425.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/20129"},{"kind":"premium","label":"Health Shield Inclusive_ICIHLIP25045V012425","pages":null,"fetched_at":"2026-10-20 02:06:24+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/rate-chart--health-shield-inclusive-icihlip25045v012425.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/19637"},{"kind":"proposal","label":"Health Shield Inclusive_ICIHLIP25045V012425","pages":null,"fetched_at":"2026-10-20 02:23:07+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/proposal-form--health-shield-inclusive-icihlip25045v012425.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/19676"},{"kind":"proposal","label":"Health Shield Inclusive_ICIHLIP25045V012425","pages":null,"fetched_at":"2026-10-20 02:23:19+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/proposal-form--health-shield-inclusive-icihlip25045v0124258c0007ff45fd68ff8a0df0055f8afa9f.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425/document/19678"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"ICICI LOMBARD General Insurance official website","url":"https://www.icicilombard.com","note":"Website as listed by IRDAI. Not checked: the site blocks automated requests (bot wall) for our crawler on 2026-10-19; we do not bypass walls."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Health Shield Inclusive_ICIHLIP25045V012425 (UIN ICIHLIP25045V012425), IndiaInsurances, https://indiainsurances.com/policy/icici-lombard-general-insurance/health-shield-inclusive-icihlip25045v012425-icihlip25045v012425"}