{"uin":"ICIHLIP27056V062627","name":"HealthAdvantEdge_CIS ApexPlus","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627","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 AdvantEdge is a health indemnity policy with individual and floater sum insured options and policy periods of one, two or three years. It covers inpatient treatment, day care, 60 days pre-hospitalisation, 180 days post-hospitalisation, AYUSH, road and air ambulance, donor expenses and domiciliary treatment, with optional covers such as maternity, BeFit, claim protector, worldwide cover, voluntary co-payment and voluntary deductible.","analysis":{"state":"machine","analysed_at":"2026-10-20 04:28:08.213338+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":["Apex Plus Plan","Prime Plus Plan"],"display":"Apex Plus Plan; Prime Plus Plan","note":null,"quote":"Name of Insurance Product/Policy Health AdvantEdge (Apex Plus Plan) ... Name of Insurance Product/Policy Health AdvantEdge (Prime Plus Plan)","sources":[{"clause":"Row 1","heading":"Name of Insurance Product/Policy Health AdvantEdge (Apex Plus Plan)","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/19824#c-row-1"},{"clause":"Row 1","heading":"Name of Insurance Product/Policy Health AdvantEdge (Prime Plus Plan)","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20735#c-row-1"}],"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":"You can opt for a policy period of one year, two years or three years.","display":"One year, two years or three years","note":null,"quote":"Policy Tenure: You can opt for a Policy with Policy period of one year or two years or three years","sources":[{"clause":"Section 2","heading":"SALIENT FEATURES & BENEFITS","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20104#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 planned hospitalisation and within 24 hours of emergency hospitalisation. For reimbursement, claim information must be provided immediately and in any event within 10 days of hospitalisation.","display":"Cashless: 48 hours before planned hospitalisation or within 24 hours of emergency; reimbursement: immediately and within 10 days of hospitalisation","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 and in any event within 10 days of Hospitalisation","sources":[{"clause":null,"heading":"Pre-authorization","page":72,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-pre-authorization"}],"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. ... d) 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":null,"heading":"2. Claim Documents","page":73,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-2-claim-documents"}],"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":"The company shall settle or reject a claim within 15 days from receipt of the claim along with the claim form. If investigation is warranted, it must be completed not later than 30 days from receipt of the last necessary document, and delay beyond the stipulated 45 days attracts interest at 2% above bank rate.","display":"15 days from receipt of claim with claim form; investigation within 30 days from last necessary document; delay beyond 45 days attracts 2% above bank rate","note":null,"quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of receipt of claim along with the claim form. ... it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document ... In case of delay beyond stipulated 45 days, the Company shall be liable to pay interest to the policyholder at a rate 2% above the bank rate","sources":[{"clause":null,"heading":"3. Claim Settlement (provision for Penal Interest)","page":62,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-3-claim-settlement-provision-for-penal-interest"},{"clause":"32(iii)","heading":null,"page":62,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-iii"},{"clause":"32(iv)","heading":null,"page":62,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-iv"}],"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 - Code- Excl01","Specified Disease/Procedure Waiting Period/Specific Waiting Period- Code- Excl02","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","Investigation & Evaluation- Code- Excl04","Rest Cure, rehabilitation and respite care- Code- Excl05","Obesity/ Weight Control: Code- Excl06","Change-of-Gender treatments: Code- Excl07","Cosmetic or plastic Surgery: Code- Excl08","Hazardous or Adventure sports: Code- Excl09","Breach of law: Code- Excl10","Excluded providers: Code- Excl 11","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- Excl 12","Sterility and lnfertility: Code- Excl 17","Maternity: Code Excl18","Treatment taken outside the geographical limits of India","Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)"],"display":"PED, specific waiting-period conditions, 30-day illness waiting period, investigation and evaluation, rest cure/rehabilitation/respite care, obesity not meeting conditions, change of gender, cosmetic surgery, hazardous sports, breach of law, excluded providers, alcohol/drug abuse, sterility and infertility, maternity unless optional cover applies, treatment outside India unless eligible, and intentional self-injury","note":null,"quote":"Excl01 Pre-Existing Diseases - Code- Excl01 ... Excl02 Specified Disease/Procedure Waiting Period/Specific Waiting Period- Code- Excl02 ... 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 ... Excl04 Investigation & Evaluation- Code- Excl04 ... Excl05 Rest Cure, rehabilitation and respite care- Code- Excl05 ... Excl06 Obesity/ Weight Control: Code- Excl06 ... Excl07 Change-of-Gender treatments: Code- Excl07 ... Excl08 Cosmetic or plastic Surgery: Code- Excl08 ... Excl09 Hazardous or Adventure sports: Code- Excl09 ... Excl10 Breach of law: Code- Excl10 ... Excl11 Excluded providers: Code- Excl 11 ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- Excl 12 ... Excl17 Sterility and lnfertility: Code- Excl 17 ... Maternity: Code Excl18 ... Treatment taken outside the geographical limits of India. This exclusion shall not be applicable for policies with Annual Sum Insured Rs. 25 lakhs and above ... Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)","sources":[{"clause":"Excl01","heading":"Pre-Existing Diseases - Code- Excl01","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl01"},{"clause":"Excl02","heading":"Specified Disease/Procedure Waiting Period/Specific Waiting Period- Code- Excl02","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl02"},{"clause":"Excl02(a)","heading":null,"page":58,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl02-a-3"},{"clause":"Excl04","heading":"Investigation & Evaluation- Code- Excl04","page":58,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation and respite care- Code- Excl05","page":58,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control: Code- Excl06","page":58,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl06"},{"clause":"Excl07","heading":"Change-of-Gender treatments: Code- Excl07","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl07"},{"clause":"Excl08","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl08"},{"clause":"Excl09","heading":"Hazardous or Adventure sports: Code- Excl09","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl09"},{"clause":"Excl10","heading":"Breach of law: Code- Excl10","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl10"},{"clause":"Excl11","heading":"Excluded providers: Code- Excl 11","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl11"},{"clause":"Excl12","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl12"},{"clause":"Excl17","heading":"Sterility and lnfertility: Code- Excl 17","page":60,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl17"},{"clause":"Excl18","heading":"Maternity: Code Excl18","page":60,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl18"},{"clause":"25","heading":null,"page":61,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-25"},{"clause":"31","heading":"Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)","page":62,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-31"}],"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":"Complaints may first be made to ICICI Lombard through its website, toll-free number, email, address or branch grievance cell. If not satisfied, the insured may contact the grievance officer, then IRDAI through Bima Bharosa or IGCC, and may also approach the Insurance Ombudsman.","display":"First contact ICICI Lombard by website, 1800 2666, customersupport@icicilombard.com, address or branch grievance cell; then grievance officer, IRDAI/Bima Bharosa/IGCC, and Insurance Ombudsman","note":null,"quote":"In case of any grievance the insured person may contact the Company through\nWebsite: www.icicilombard.com Toll free number: 1800 2666 Email: customersupport@icicilombard.com Address- 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 officer ... the insured person may also approach Insurance Regulatory and Development Authority (IRDA) through the Bima Bharosa Portal ... Insured may also approach Insurance Ombudsman","sources":[{"clause":null,"heading":"15. Nomination","page":66,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-15-nomination"}],"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 ₹3,00,000 and maximum Sum Insured is ₹3,00,00,000.","display":"₹3,00,000 to ₹3,00,00,000","note":null,"quote":"Annual Sum Insured: This denotes the maximum amount of cover available to You for a Policy Period of one year. Minimum Sum Insured: ₹3,00,000 Maximum Sum Insured: ₹3,00,00,000","sources":[{"clause":"Section 2","heading":"SALIENT FEATURES & BENEFITS","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20104#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":"Accident claims are excepted if covered.","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","sources":[{"clause":"Excl02(a)","heading":null,"page":58,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl02-a-3"}],"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":24},"display":"24 months","note":"Apex Plus and Prime Plus CIS state 24 months; the policy wording says 0 Months/24 months depending on plan opted.","quote":"Declared & accepted Pre-existing diseases will be covered after 24 months of continuous coverage. ... Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 0 Months/24 months (depending on plan opted) of continuous coverage after the date of inception of the first policy with insurer as selected by the Insurer","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":5,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/19824#c-icici-lombard-general-insurance-company-limited-5"},{"clause":"Excl01","heading":"Pre-Existing Diseases - Code- Excl01","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#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":"Apex Plus and Prime Plus CIS state 24 months; the policy wording says 0 months/24months depending on plan opted.","quote":"Specific waiting period (Not applicable for claims arising due to an accident): First 24 months, for specific Illness and treatment. ... Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 0 months/24months (depending on plan opted) of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":5,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/19824#c-icici-lombard-general-insurance-company-limited-5"},{"clause":"Excl02(a)","heading":null,"page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl02-a"}],"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":["Any types of gastric or duodenal ulcers","Benign prostatic hypertrophy","All types of sinuses","Hemorrhoids","Dysfunctional uterine bleeding","Endometriosis","Stones in the urinary and biliary systems","Surgery on ears/tonsils/adenoids/ paranasal sinuses","Cataracts","Hernia of all types and Hydrocele","Fistulae in anus","Fissure in anus","Fibromyoma","Hysterectomy","Surgery for any skin ailment","Surgery on all internal or external tumours/ cysts/ nodules/polyps of any kind including breast lumps with exception of Malignancy","Dialysis required for Chronic Renal Failure.","Joint Replacement Surgeries unless necessitated by Accident happening after the Policy risk inception date.","Dilatation and curettage","Varicose Veins and Varicose Ulcers","Non Infective Arthritis and other form arthritis","Gout and Rheumatism","Prolapse inter Vertebral Disc and Spinal Diseases including spondylitis/spondylosis unless arising from Accident","Hypertension","Diabetes","Cardiac Conditions"],"display":"Listed specific diseases/procedures include ulcers, BPH, sinuses, hemorrhoids, endometriosis, stones, ENT surgery, cataract, hernia/hydrocele, fistula/fissure, hysterectomy, skin surgery, tumours/cysts/nodules/polyps, chronic renal failure dialysis, joint replacement, D&C, varicose veins/ulcers, non-infective arthritis, gout/rheumatism, spinal diseases, plus 90-day waiting for hypertension, diabetes and cardiac conditions","note":null,"quote":"List of specific diseases/procedures\n1. Any types of gastric or duodenal ulcers\n2. Benign prostatic hypertrophy\n3. All types of sinuses\n4. Hemorrhoids\n5. Dysfunctional uterine bleeding\n6. Endometriosis\n7. Stones in the urinary and biliary systems ... 8. Surgery on ears/tonsils/adenoids/ paranasal sinuses\n9. Cataracts,\n10. Hernia of all types and Hydrocele\n11. Fistulae in anus\n12. Fissure in anus\n13. Fibromyoma\n14. Hysterectomy\n15. Surgery for any skin ailment ... 16. Surgery on all internal or external tumours/ cysts/ nodules/polyps of any kind including breast lumps with exception of Malignancy\n17. Dialysis required for Chronic Renal Failure.\n18. Joint Replacement Surgeries unless necessitated by Accident happening after the Policy risk inception date. ... 19. Dilatation and curettage\n20. Varicose Veins and Varicose Ulcers\n21. Non Infective Arthritis and other form arthritis\n22) Gout and Rheumatism\n23) Prolapse inter Vertebral Disc and Spinal Diseases including spondylitis/spondylosis unless arising from Accident ... 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\nii) Diabetes\niii) Cardiac Conditions","sources":[{"clause":"Excl02(f)","heading":null,"page":57,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl02-f"},{"clause":"Excl02(a)","heading":null,"page":58,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl02-a-2"}],"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":"years","amount":5},"display":"five continuous years","note":"For enhanced sum insured, five continuous years applies from the date of enhancement on the enhanced limits.","quote":"After completion of five continuous years 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 five continuous years is called as moratorium period.","sources":[{"clause":null,"heading":"13. Moratorium Period","page":65,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-13-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":"The insured may port the policy to another insurer and is entitled to transfer credits gained to the extent of the sum insured and benefits available in the previous policy, subject to underwriting; the request must be made at least 30 days before and not earlier than 60 days from renewal due date.","display":"Can port to another insurer with transfer of credits, subject to underwriting; 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. ... 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":"32(a)","heading":null,"page":65,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-a-3"},{"clause":"32(b)","heading":null,"page":65,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-b-3"}],"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/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20104#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":"For individual products, renewal premium loadings are at portfolio level and not based on any individual policy claim experience.","display":"No individual claim-based renewal loading; portfolio-level loadings only","note":null,"quote":"For individual products, the loadings on renewal premium shall be at portfolio and not based upon any individual Policy claim experience. However, discount in premium may be provided by us to You for good claims experience.","sources":[{"clause":"32(b)(iv)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-b-iv"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"The policyholder may cancel by giving 7 days’ written notice. For terms up to one year, proportionate premium for the unexpired policy period is refunded if no claims were made; for terms over one year, premium is refunded for unexpired policy years where risk coverage has not commenced.","display":"7 days’ written notice; proportionate unexpired premium for up to 1-year term if no claim; unexpired policy-year premium for terms over 1 year where risk has not commenced","note":"Free-look cancellations follow the Free Look clause.","quote":"The policyholder may cancel this policy by giving 7 days’ written notice and in such an event, the Company shall refund premium for the unexpired policy period as detailed below. ... 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":"32(a)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-a-2"},{"clause":"32(a)(i)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-a-i"},{"clause":"32(a)(ii)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-a-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":"Treatment must be taken in India only, but worldwide treatment is available for policies with Annual Sum Insured INR25 Lakh and above.","display":"India only; worldwide treatment for Annual Sum Insured INR25 Lakh and above","note":null,"quote":"All medical treatment for the purpose of this insurance will have to be taken in India only. For policies with Annual Sum Insured INR25 Lakh and above, Worldwide treatment will be available.","sources":[{"clause":null,"heading":"21. Territorial Limit","page":68,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-21-territorial-limit"}],"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":"Does not apply to policies with tenure of less than a year.","quote":"Every insured of new individual 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","sources":[{"clause":null,"heading":"5. Multiple policies","page":63,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-5-multiple-policies"}],"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":15},"display":"15 days for monthly mode; 30 days in all other cases","note":"Monthly premium mode has 15 days; all other cases have 30 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":"32(b)(vi)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-b-vi"}],"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":"The policy can be offered from 6 years to 65 years for an individual. Children aged 91 days to 5 years can be insured only under a floater plan; maximum age for dependent children under a floater policy is 25 years.","display":"Individual: 6 years to 65 years; children 91 days to 5 years only under floater; dependent children up to 25 years under floater","note":null,"quote":"Entry Age: This Policy can be offered to an individual with minimum age of 6 years and maximum age of 65 years. Children between ages of 91 days to 5 years can be insured only under a floater plan only. Maximum age for dependent children under Floater Policy is 25 years.","sources":[{"clause":"1","heading":"Entry Age","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20104#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":["Half Yearly","Quarterly","Monthly"],"display":"Half Yearly, Quarterly or Monthly instalments","note":"Annual payment mode is not expressly listed in the cited instalment clause.","quote":"If the insured person has opted for Payment of Premium on an installment basis i.e. Half Yearly, Quarterly or Monthly, as mentioned in Your Policy Schedule/certificate of insurance","sources":[{"clause":"32(b)(vi)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-b-vi"}],"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":["Maternity Cover","New Born Baby Cover","Vaccinations for new born baby in the first year","Critical Illness","Personal Accident","Nursing at Home","Compassionate Visit","BeFit","Claim Protector","Sum Insured Protector","Voluntary Co-Payment","Voluntary Deductible","Worldwide Cover","Preventive Health Check-up (Reimbursement)","Room Rent Capping"],"display":"Maternity, newborn baby, newborn vaccination, critical illness, personal accident, nursing at home, compassionate visit, BeFit, claim protector, sum insured protector, voluntary co-payment, voluntary deductible, worldwide cover, preventive health check-up reimbursement, and room rent capping","note":"Voluntary Co-Payment and Voluntary Deductible are listed in the optional-cover section though the wording says additional premium is not received for those two.","quote":"The Covers listed below shall be available to the Insured Person only if the additional premium has been received by Us ... 1. Maternity Cover ... 2. New Born Baby Cover ... 3. Vaccinations for new born baby in the first year ... 4. Critical Illness ... 5. Personal Accident ... 6. Nursing at Home ... 7. Compassionate Visit ... 8. BeFit ... 9. Claim Protector ... 10. Sum Insured Protector ... 11. Voluntary Co-Payment ... 12. Voluntary Deductible ... 13. Worldwide Cover ... 14. Preventive Health Check-up (Reimbursement) ... 15. Room Rent Capping","sources":[{"clause":"22","heading":"Incentives associated with vaccination against pneumococcal disease","page":34,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-22"},{"clause":null,"heading":"1. Maternity Cover","page":35,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-maternity-cover"},{"clause":null,"heading":"2. New Born Baby Cover","page":36,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-2-new-born-baby-cover"},{"clause":null,"heading":"3. Vaccinations for new born baby in the first year","page":36,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-3-vaccinations-for-new-born-baby-in-the-first-ye"},{"clause":null,"heading":"4. Critical Illness","page":36,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-4-critical-illness"},{"clause":null,"heading":"5. Personal Accident","page":42,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-5-personal-accident"},{"clause":null,"heading":"6. Nursing at Home","page":46,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-6-nursing-at-home"},{"clause":null,"heading":"7. Compassionate Visit","page":46,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-7-compassionate-visit"},{"clause":null,"heading":"8. BeFit","page":46,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-8-befit"},{"clause":null,"heading":"9. Claim Protector","page":52,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-9-claim-protector"},{"clause":null,"heading":"10. Sum Insured Protector","page":53,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-10-sum-insured-protector"},{"clause":null,"heading":"11. Voluntary Co-Payment","page":54,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-11-voluntary-co-payment"},{"clause":null,"heading":"12. Voluntary Deductible","page":54,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-12-voluntary-deductible"},{"clause":null,"heading":"13. Worldwide Cover","page":54,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-13-worldwide-cover"},{"clause":null,"heading":"14. Preventive Health Check-up (Reimbursement)","page":55,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-14-preventive-health-check-up-reimbursement"},{"clause":null,"heading":"15. Room Rent Capping","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-15-room-rent-capping"}],"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 grace period for renewal. If premium is paid in instalments during the policy period, the insurer shall offer coverage during the grace period.","display":"Renewal grace: coverage not available; instalment premium grace: coverage offered 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 insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period.","sources":[{"clause":"32(b)(iii)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-b-iii"},{"clause":"32(b)(vi)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-32-b-vi"}],"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":"For policies with Annual Sum Insured up to Rs. 4 Lakhs, room rent is capped at 1% of Annual Sum Insured. For Annual Sum Insured Rs. 5 Lakhs and above, the policy wording states there is no room rent capping; an optional Room Rent Capping cover can cap Rs. 5 Lakhs to Rs. 20 Lakhs policies to a Single Private AC Room.","display":"Up to Rs. 4 Lakhs: 1% of Annual Sum Insured; Rs. 5 Lakhs and above: no room rent capping; optional Rs. 5 Lakhs to Rs. 20 Lakhs cap to Single Private AC Room","note":"The Room Rent Capping cover is an optional cover in the policy wording.","quote":"For policies with Annual Sum Insured options up to Rs. 4 Lakhs- room rent charges shall be capped at 1 % of Annual Sum Insured ... For policies with Annual Sum Insured options Rs. 5 Lakhs and above, there will be no room rent capping. ... For policies Annual Sum Insured options Rs. 5 Lakhs to Rs. 20 Lakhs – room rent charges shall be capped to a Single Private AC Room","sources":[{"clause":"1(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-a"},{"clause":"1(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-b"},{"clause":null,"heading":"15. Room Rent Capping","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-15-room-rent-capping"}],"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":"quote-verified","value":"The base wording does not restrict room category for Rs. 5 Lakhs and above, but the optional Room Rent Capping cover caps Rs. 5 Lakhs to Rs. 20 Lakhs policies to a Single Private AC Room.","display":"Single Private AC Room if Room Rent Capping cover applies for Rs. 5 Lakhs to Rs. 20 Lakhs; otherwise no room category cap for Rs. 5 Lakhs and above in policy wording","note":"For Annual Sum Insured up to Rs. 4 Lakhs, the limit is a rupee/percentage cap rather than a room category.","quote":"For policies with Annual Sum Insured options Rs. 5 Lakhs and above, there will be no room rent capping. ... For policies Annual Sum Insured options Rs. 5 Lakhs to Rs. 20 Lakhs – room rent charges shall be capped to a Single Private AC Room","sources":[{"clause":"1(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-b"},{"clause":null,"heading":"15. Room Rent Capping","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-15-room-rent-capping"}],"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":"For policies with Annual Sum Insured up to Rs. 4 Lakhs, intensive care unit charges are capped at 2% of Annual Sum Insured. For Annual Sum Insured Rs. 5 Lakhs and above, there is no ICU capping.","display":"Up to Rs. 4 Lakhs: 2% of Annual Sum Insured; Rs. 5 Lakhs and above: no ICU capping","note":null,"quote":"For policies with annual sum insured options up to Rs. 4 Lakhs – intensive care unit charges shall be capped at 2% of Annual Sum Insured ... For policies with annual sum insured options Rs. 5 Lakhs and above- there shall be no capping on intensive care unit charges","sources":[{"clause":"1(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-a-2"},{"clause":"1(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-b-2"}],"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 specified, the insured bears a rateable proportion of associated medical expenses. Proportionate deductions are not applicable for ICU charges and for hospitals or expenses without differential billing by room category.","display":"Yes, if room category/limit is higher; not applicable for ICU charges or where differential billing is not used","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 ... Proportionate deductions are not applicable for ICU charges ... Proportionate deductions shall not be applicable for hospitals which do not follow differential billing","sources":[{"clause":"1(b)(i)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-b-i"},{"clause":"1(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-b-3"},{"clause":"1(c)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-c"}],"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":"quote-verified","value":"There is no stated compulsory co-payment in the base cover. The insured can choose a Voluntary Co-payment, and if opted must bear the specified co-payment percentage of each and every admissible claim amount.","display":"None stated unless Voluntary Co-payment is opted; optional 10%/20%","note":"Voluntary Co-payment applies to all Basic Cover except Wellness Program, Preventive Health Check-up, Tele-Consultations and incentives associated with vaccination against pneumococcal disease; it does not apply to add-ons/optional covers.","quote":"The Insured Person has the choice to opt for Voluntary Co-payment and avail subsequent discount on premium. In case Voluntary Co-payment is opted as mentioned in the Policy Schedule, the Insured Person will be liable to bear the specified Co-payment percentage of admissible claim amount of each and every claim amount. ... Voluntary Co-Payment - Options available- 10%/20%","sources":[{"clause":null,"heading":"11. Voluntary Co-Payment","page":54,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-11-voluntary-co-payment"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":2,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/19824#c-icici-lombard-general-insurance-company-limited-2"}],"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":"There is no stated compulsory deductible in the base cover. The insured can choose a Voluntary Deductible, which applies on an aggregate basis for all hospitalisation expenses during the policy year under basic cover.","display":"None stated unless Voluntary Deductible is opted; optional Rs. 25,000/50,000/75,000/1,00,000 on aggregate basis","note":"Voluntary Deductible is not available for Sum Insured 25 Lakhs and above, and cannot be opted if voluntary co-payment has been opted.","quote":"The Insured Person has the choice to opt for Voluntary Deductible and avail subsequent discount on premium. In case Voluntary Deductible is opted as mentioned in the Policy Schedule, the Insured Person will be liable to bear the specified Deductible amount. ... Voluntary Deductible will apply on aggregate basis for all hospitalisation expenses during the policy year which fall under basic cover. ... Voluntary Deductible opted- Rs. 25,000/50,000/75,000/1,00,000","sources":[{"clause":null,"heading":"12. Voluntary Deductible","page":54,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-12-voluntary-deductible"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":7,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20735#c-icici-lombard-general-insurance-company-limited-7"}],"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":"not-stated","value":null,"display":null,"note":"The documents state waiting periods for named diseases/procedures and several benefit limits, but no disease/procedure payment caps such as cataract or knee replacement sub-limits were stated.","quote":null,"sources":[],"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":60},"display":"60 days","note":"Payable if the inpatient/daycare/AYUSH claim is accepted; nursing care at home is excluded from pre-hospitalisation expenses.","quote":"We will cover the Pre-hospitalization Medical Expenses incurred in respect of the Insured Person immediately 60 days before the Insured Person’s Admission to Hospital","sources":[{"clause":"4","heading":"Pre- Hospitalisation Medical Expenses","page":14,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-4"}],"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":180},"display":"180 days","note":"Payable if the inpatient/daycare/AYUSH claim is accepted; nursing care at home is excluded from post-hospitalisation expenses.","quote":"We will cover the Post-hospitalization Medical Expenses incurred in respect of the Insured Person immediately 180 days following the Insured Person’s discharge from Hospital","sources":[{"clause":"5","heading":"Post Hospitalization Medical Expenses","page":14,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#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 for treatment requiring inpatient hospitalisation for less than 24 hours. The wording includes procedures such as intravenous chemotherapy, radiotherapy, hemodialysis or any other therapeutic procedure requiring specialised observation or medical care after completion.","display":"Covered up to Annual Sum Insured, including but not limited to intravenous chemotherapy, radiotherapy, hemodialysis or any other therapeutic procedure","note":"Out Patient Treatment or diagnostic services are not covered under the day care 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 ... Day Care treatment requires hospitalization as an inpatient for less than 24 hours in a Hospital. ... procedures including but not limited to intravenous chemotherapy, radiotherapy, hemodialysis or any other therapeutic procedure","sources":[{"clause":"2","heading":"Day Care Procedures/Treatment","page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-2"},{"clause":"2(i)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-2-i"},{"clause":"2(ii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-2-ii"}],"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 hospitalisation is covered if it starts on written advice of a medical practitioner and continues for at least 3 consecutive days. A separate Home Care Treatment benefit covers treatment at home up to 5% of Annual Sum Insured subject to a maximum of INR 1 Lacs with prior approval and other conditions.","display":"Domiciliary hospitalisation covered after at least 3 consecutive days; Home Care Treatment up to 5% of Annual Sum Insured, maximum INR 1 Lacs","note":"Home Care Treatment requires prior approval and is to be availed cashless through empaneled service providers where available.","quote":"We will cover the Medical Expenses incurred in respect of the Domiciliary Hospitalization of the Insured Person during the Policy Period provided that the Domiciliary Hospitalization has commenced on the written advice of a medical practitioner and continues for at least 3 consecutive days ... We will cover the Medical Expenses incurred by the Insured Person on Home Care Treatment up to 5% of Annual Sum Insured subject to a maximum of INR 1 Lacs provided that","sources":[{"clause":"12","heading":"Domiciliary Hospitalization","page":18,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-12"},{"clause":"13","heading":"Home Care Treatment","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-13"}],"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":"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":null,"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 Hospitalized for AYUSH Treatment at a AYUSH Hospital or AYUSH Day Care Centre.","sources":[{"clause":"6","heading":"In Patient AYUSH Hospitalization","page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#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 during hospitalisation up to the Annual Sum Insured, including uterine artery embolization and HIFU, immunotherapy, vaporisation of the prostate, hematopoietic stem cell therapy for bone marrow transplant, 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 modern treatments including immunotherapy, stem cell therapy for bone marrow transplant, oral chemotherapy and robotic surgeries","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 ... 4 | Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions ... 6 | Oral Chemotherapy\n7 | Robotic surgeries","sources":[{"clause":"3","heading":"Technological Advancements and Treatments","page":13,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#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 expenses for harvesting the organ donated to the insured person are covered up to the Annual Sum Insured, subject to the Transplantation of Human Organs Act 1994 and other conditions.","display":"Covered up to Annual Sum Insured for organ donor in-patient harvesting expenses","note":"Pre- and post-hospitalisation expenses, screening expenses, organ acquisition, organ transportation or preservation, and complications of the donor 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 Transplantation of Human Organs Act 1994","sources":[{"clause":"11","heading":"Donor Expenses","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-11"}],"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 reimbursement limited to 1% of Annual Sum Insured up to INR 10,000 per claim, and cashless road ambulance covered as per actuals. Domestic air ambulance is covered up to the Annual Sum Insured for life-threatening emergency transport within India to the nearest hospital.","display":"Road ambulance: 1% of Annual Sum Insured up to INR 10,000 on reimbursement, actuals on cashless; air ambulance: up to Annual Sum Insured","note":"Air ambulance does not cover transport outside India.","quote":"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 INR 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 domestic road ambulance will be covered as per actuals. ... We will cover the expenses incurred on Air Ambulance services up to the Annual Sum Insured","sources":[{"clause":"9(i)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-9-i"},{"clause":"10","heading":"Domestic Air Ambulance Cover","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-10"}],"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":"quote-verified","value":"Reset Benefit resets up to 100% of the Annual Sum Insured in a policy year. For Annual Sum Insured below Rs. 10 Lakhs it triggers only once; for Rs. 10 Lakhs and above it triggers unlimited times, but not for the first claim and not for the same illness/injury or related complications including relapse within 45 days for the same insured person.","display":"Up to 100% reset; once if SI below Rs. 10 Lakhs, unlimited if SI Rs. 10 Lakhs and above; not for first claim or same illness relapse within 45 days","note":"Applies only if the claim is admissible under Inpatient Treatment or Daycare Procedure/Treatment; unused reset does not carry forward.","quote":"We will reset up to 100% of the Annual Sum Insured, for any illness/disease/injury for the Insured Person in a Policy Year ... For policies with annual sum insured less than Rs. 10 Lakhs reset benefit will be triggered only once ... For policies with annual sum insured Rs. 10 Lakhs and above reset benefit will be triggered unlimited times ... The Reset Benefit will not be triggered for the first claim made during the Policy Year ... The Reset Benefit will not be available for an Illness /Injury or related complications including but not limited to any relapse within 45 days","sources":[{"clause":"8","heading":"Reset Benefit","page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-8"}],"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":"quote-verified","value":"Loyalty bonus is 20% of the expiring or renewed Annual Sum Insured, whichever is lower, at the end of each policy year irrespective of a claim, up to a maximum of 100% of Annual Sum Insured. It is not reduced after a claim.","display":"20% each policy year, maximum 100%, irrespective of claims; not reduced after a claim","note":null,"quote":"We will provide a Loyalty bonus of 20% of expiring or renewed Annual Sum Insured (whichever is lower) at the end of each Policy Year irrespective of a claim being initiated in the Policy Year ... The Loyalty bonus will not be accumulated for more than 100% of the Annual Sum Insured ... In the event of Claim, under the Policy during any subsequent Policy Year, the credited Loyalty bonus will not be reduced.","sources":[{"clause":"17","heading":"Loyalty bonus","page":30,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-17"},{"clause":"17(x)","heading":null,"page":31,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-17-x"}],"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":"The base inpatient cover pays for medicines, drugs and consumables except excluded non-medical items in Annexure II. If the optional Claim Protector is bought and a claim is accepted under inpatient or daycare cover, List I non-payable items related to that claim become payable.","display":"Base covers medicines, drugs and consumables other than excluded non-medical items; optional Claim Protector can pay List I non-payables up to Sum Insured","note":"Claim Protector is an optional cover.","quote":"Anaesthesia, blood, oxygen, operation theatre charges, medicines, drugs and consumables (other than those specified in the list of excluded expenses (non-medical) in Annexure II. ... If a claim has been accepted under the “Inpatient Treatment” or “Daycare Procedure/Treaments” Cover, the items which are included in the List I- Items for which coverage is not available in the Policy of Annexure II, which are non – payable, to the particular claim, will become payable.","sources":[{"clause":"1(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-b-2"},{"clause":null,"heading":"9. Claim Protector","page":52,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-9-claim-protector"}],"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 expenses are excluded unless optional Maternity Cover is opted. Optional Maternity Benefit A covers up to 10% of Annual Sum Insured subject to maximum INR 1 Lakhs with 24 months waiting; Benefit B covers up to 10% of Annual Sum Insured subject to maximum INR 10 Lakhs with 9 months waiting.","display":"Excluded unless optional Maternity Cover is opted; A: 10% ASI max INR 1 Lakhs, 24 months; B: 10% ASI max INR 10 Lakhs, 9 months","note":"Both Maternity Benefit A and B are optional covers and are not available for Annual Sum Insured 3 and 4 Lakhs.","quote":"Maternity: Code Excl18 ... This exclusion will stand modified to the effect to cover not be applicable in case optional cover 1 Maternity Cover- a) Maternity Benefit_A or b) Maternity benefit_B has been opted. ... This optional benefit covers the medical expenses up to 10% of the Annual Sum Insured; subject to a maximum limit of INR 1 Lakhs ... This benefit will have a waiting period of 24 months ... subject to a maximum limit of INR 10 Lakhs ... The benefit will have a waiting period of 9 months","sources":[{"clause":"Excl18","heading":"Maternity: Code Excl18","page":60,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl18"},{"clause":"Excl18(ii)","heading":null,"page":60,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl18-ii"},{"clause":"22(a)(i)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-22-a-i"},{"clause":"22(a)(iii)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-22-a-iii"},{"clause":"22(b)(i)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-22-b-i"},{"clause":"22(b)(iii)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-22-b-iii"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New Born Baby Cover is an optional cover available only if Maternity Cover was opted and a maternity claim was accepted. It covers hospitalisation expenses of the newborn for a maximum period up to 90 days from birth, up to twice the maternity sum insured.","display":"Optional; newborn hospitalisation up to 90 days from birth, limit twice the maternity sum insured","note":"New Born Baby Cover is an optional cover.","quote":"We will cover the Medical Expenses incurred by the Insured Person on Hospitalization of a “New born Baby” during each Policy Year of Policy Period subject to the maximum limit of twice of the maternity sum Insured. ... This add on/ Optional Cover will be provided only if You have opted for the Maternity Cover and We have accepted a claim under Maternity cover under this policy. ... for a maximum period up to 90 days from the date of birth of the baby","sources":[{"clause":null,"heading":"2. New Born Baby Cover","page":36,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-2-new-born-baby-cover"}],"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":"quote-verified","value":"OPD treatment is excluded in the base policy, except specific covers such as animal bite vaccination and tele-consultations. The optional BeFit cover provides cashless outpatient consultations, diagnostics, minor procedures, pharmacy, physiotherapy, e-counselling and diet/nutrition e-consultation, subject to the selected BeFit plan limits.","display":"Base OPD excluded; animal bite vaccination up to Rs. 10,000 and tele-consultations included; optional BeFit covers OPD services on cashless basis subject to plan limits","note":"BeFit is an optional cover.","quote":"Any expenses incurred on Out Patient treatment. This exclusion will not be applicable in case optional cover 8. BeFit has been opted ... We will cover Medical Expenses of Out-Patient Treatment of Insured Person for vaccinations or immunizations for treatment post an animal bite, up to Rs. 10,000. ... There shall be no maximum limit on the count of Tele-Consultations ... All benefits under the BeFit cover can be availed only on cashless basis via our mobile application","sources":[{"clause":"Excl18(c)","heading":"Biological attack or weapons","page":61,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-excl18-c"},{"clause":"14","heading":"Animal Bite (Vaccination)","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-14"},{"clause":"21(iii)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-21-iii"},{"clause":null,"heading":"8. BeFit","page":46,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-8-befit"}],"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 zone-based and depends on the insured person's city of residence and pincode. The country is divided into four zones.","display":"Yes, premium depends on city of residence and pincode across 4 zones","note":null,"quote":"For the purpose of premium computation, the country has been divided into 4 zones. ... The premium will depend on the city of residence and pincode of the insured person. Please inform us immediately in case of any change in the same. Not doing so, may impact your claim admissibility","sources":[{"clause":null,"heading":"18. Zone based premium","page":67,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-18-zone-based-premium"}],"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. The insurer pays treatment costs directly to the network provider to the extent pre-authorisation is approved.","display":"Available at Network Providers, subject to pre-authorisation","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":71,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-1-claims-procedure"},{"clause":null,"heading":"Health AdvantEdge Policy Wordings","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-health-advantedge-policy-wordings"}],"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":"ICICI Lombard / 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":"Pre-authorization","page":72,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435#c-pre-authorization"}],"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":true,"display":"Yes, floater cover available for immediate family under the same sum insured","note":null,"quote":"Floater Policy: You can avail a floater cover and get Your immediate family covered for the same sum insured under a single Policy by paying one premium amount.","sources":[{"clause":"3","heading":"Floater Policy","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20104#c-3"}],"law":[]}],"documents":[{"kind":"wording","label":"HealthAdvantEdge_Policy Wordings_ICIHLIP27056V062627","pages":89,"fetched_at":"2026-10-20 02:39:41+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/health-advantedge8c0007ff45fd68ff8a0df0055fa75ed5.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20435"},{"kind":"prospectus","label":"HealthAdvantEdge_Prospectus and Sales Literature","pages":28,"fetched_at":"2026-10-20 02:16:57+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/health-advantedge-prospectus-and-sales-literature.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20104"},{"kind":"cis","label":"HealthAdvantEdge_CIS ApexPlus","pages":12,"fetched_at":"2026-10-20 01:54:21+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/cis_health-advantedge-apex-plus.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/19824"},{"kind":"cis","label":"HealthAdvantEdge_CIS PrimePlus","pages":12,"fetched_at":"2026-10-20 02:51:45+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/healthadvantedge_cis-prime-plus.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627/document/20735"}],"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":"HealthAdvantEdge_CIS ApexPlus (UIN ICIHLIP27056V062627), IndiaInsurances, https://indiainsurances.com/policy/icici-lombard-general-insurance/healthadvantedge-cis-apexplus-icihlip27056v062627"}