ICICI Lombard MaxProtect health insurance plan is a multiple-benefit provider plan that comes with affordable premiums. It has two variants ie, Classic and Premium with a whopping large sum insured of INR 1 Crore.
The plan offers other benefits like exclusive worldwide coverage, modern-day treatment procedures, reset benefits, multi-year policy discounts and much more. The details of the ICICI Lombard MaxProtect health plan are further mentioned below. Read the article thoroughly and make an informed decision before investing in this plan.
Eligibility criteria for ICICI Lombard MaxProtect Health Insurance
Check here, the eligibility criteria for purchasing the plan before purchasing it:-
Entry Age
Minimum Child: 3 Months (91 Days) - 20 Years
Adult Entry Age
Adult: 21 - 65 Years
Policy Type
Individual/ Family Floater
Sum Insured
Upto 1 Cr
Policy Term
1/2/3 Years
Initial Waiting Period*
30 Days*
*The Initial Waiting Period is the period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
Benefits of ICICI Lombard MaxProtect Health Insurance
For investing in the ICICI Lombard MaxProtect Health Insurance plan, you must be aware of the benefits it offers. The major features that are attached to this plan are mentioned below:-
Access to modern healthcare
The plan covers expenses against stem cell therapy, oral chemotherapy, robotic surgeries, etc if recommended. It's to make sure that you get access to technological modern-day procedures.
Worldwide policy coverage
There's optional global coverage for medical treatment and daycare procedures after completing your specified waiting period.
Assured cumulative bonuses
For each claim-free year, the policyholder receives a guaranteed cumulative bonus of 20%. Your sum insured will keep increasing at this rate until it gets to 100% of the actual sum insured.
Sum insured reset benefits
If the sum insured under this plan gets exhausted, you are free to add more sum insured for seamless and continued medical support.
Multi-year plan discounts
With a 2 or 3-year policy tenure under the ICICI Lombard MaxProtect plans, you are eligible for a 10-15% discount on overall premiums.
Tax Benefits
All the premiums paid towards ICICI Lombard MaxProtect Health Insurance plans are eligible for tax benefits under Section 80D of the Income Tax Act.
Choose your ICICI Lombard MaxProtect Health Insurance
This plan has two variants of which the coverage benefits are given below:-
Read more specifications in the brochure.
SI Up to INR 1 Crore
In-patient & Out-patient Coverage
Room Rent
Covered up to SI for all rooms (except suites)
ICU Charges
Covered up to SI
Pre-Hospitalization
Covered for up to 60 days
Post-Hospitalization
Covered for up to 180 days
Domiciliary Hospitalization
Covered up to SI
Daycare Treatment
Covered; excluding specific conditions
OPD Charges
Not Covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Not Covered
No Claim Bonus
20% every claim-free year up to 100%
Automatic Restoration
Applicable
Daily Hospital Cash
Not Applicable
Organ Donor
Covered up to SI
Maternity Cover
Not Covered
New Born Baby Cover
Not Covered
Alternative Treatments
AYUSH Treatment
Covered up to SI
IVF Treatment
Not Covered
Modern Treatment
Covered up to SI
Emergency Coverage
Ambulance
INR 10,000
Air Ambulance
Not covered
Compassionate Travel
Not Applicable
Global Coverage
Not covered
Wellness Programmes
E-Consultation
Unlimited
Health Check-Up
Not covered
Second Medical Opinion
Not Covered
Vaccination
Not Covered
Limitations
Co-payment
Applicable
Sub-limits
Available
In-patient & Out-patient Coverage
Room Rent
Covered up to SI for all rooms (except suites)
ICU Charges
Covered up to SI
Pre-Hospitalization
Covered for up to 60 days
Post-Hospitalization
Covered for up to 180 days
Domiciliary Hospitalization
Covered up to SI
Daycare Treatment
Covered; excluding specific conditions
OPD Charges
Not Covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Not Covered
No Claim Bonus
20% every claim-free year up to 100%
Automatic Restoration
Applicable
Daily Hospital Cash
Not Applicable
Organ Donor
Covered up to SI
Maternity Cover
Not Covered
New Born Baby Cover
Not Covered
Alternative Treatments
AYUSH Treatment
Covered up to SI
IVF Treatment
Not Covered
Modern Treatment
Covered up to SI
Emergency Coverage
Ambulance
INR 10,000
Air Ambulance
Up to SI
Compassionate Travel
Not Applicable
Global Coverage
Up to SI; Maximum up to INR 3 Crore
Wellness Programmes
E-Consultation
Unlimited
Health Check-Up
Up to INR 10,000 per policy
Second Medical Opinion
Upto SI
Vaccination
Not Covered
Limitations
Co-payment
Applicable
Sub-limits
Available
What is Room Rent?
Room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.
Common Room categories covered under room rent are:
Private Single AC Room
Twin Sharing
General Ward
Coverage status under ICICI Lombard MaxProtect
Under ICICI Lombard MaxProtect Health Plan, the room rent is covered up to SI.
What are ICU Charges?
It is a special department in the hospitals where patients with serious medical conditions are treated.
Coverage status under ICICI Lombard MaxProtect
Under the ICICI Lombard MaxProtect Health Plan, ICU charges are covered up to SI.
What is Pre Hospitalization?
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under ICICI Lombard MaxProtect
ICICI Lombard MaxProtect Health Plan covers medical expenses incurred during pre-hospitalization up to 60 days.
What is Post Hospitalization?
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under ICICI Lombard MaxProtect
ICICI Lombard MaxProtect Health Plan covers medical expenses incurred during post-hospitalization up to 180 days for classic and premium plan variants.
What is Domiciliary Hospitalization?
Home hospitalization arrangements for the insured person due to the unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get financial coverage.
Coverage status under ICICI Lombard MaxProtect
Under the ICICI Lombard MaxProtect Health Plan, domiciliary hospitalization is covered upto SI.
What is Daycare Treatment?
Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.
Coverage status under ICICI Lombard MaxProtect
Under ICICI Lombard MaxProtect Health Plan all day care treatments are covered which does not need overnight hospitalization.
What are OPD charges?
Covers the cost of doctor consultations and prescribed medical tests that may not require hospitalization.
Coverage status under ICICI Lombard MaxProtect
ICICI Lombard MaxProtect Health Plan does not cover OPD expense
What is COVID-19 Treatment?
COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. approved Centre.
Coverage status under ICICI Lombard MaxProtect
Covid-19 Covered.
What is Cataract Treatment?
A common eye condition in which your vision gets blurred.
Coverage status under ICICI Lombard MaxProtect
ICICI Lombard MaxProtect Health Plan does not cover cataract treatment expenses
What is a No-Claim Bonus?
For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage that varies from plan to plan.
Coverage status under ICICI Lombard MaxProtect
A cumulative bonus is available under the ICICI Lombard MaxProtect Health Plan wherein the Sum Insured is increased by 100% of the Base Sum Insured in respect of each claim-free Policy Year.
What is Automatic Restoration?
Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.
Coverage status under ICICI Lombard MaxProtect
Unlimited Auto Restoration is available under ICICI Lombard MaxProtect Health Plan Unlimited (Not applicable for unlimited SI)
What is Daily Hospital Cash?
It is a cash amount that you receive each day during the time of hospitalization.
Coverage status under ICICI Lombard MaxProtect
The daily hospital cash is not available under the ICICI Lombard MaxProtect Health Plan
What is an Organ Donor Cover?
It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.
Coverage status under ICICI Lombard MaxProtect
Under the ICICI Lombard MaxProtect Health Plan, organ donor expenses are covered up to SI.
What is a Maternity Cover?
It refers to the cover that includes expenses for normal and c-section procedure deliveries.
Coverage status under ICICI Lombard MaxProtect
Maternity expense coverage is not available under the ICICI Lombard MaxProtect Health Plan
What is a New Born Baby Cover?
It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the new borncover and these common treatments can vary from plan to plan:
Congenital anomaly (conditions since birth)
Acute condition
Chronic condition
Pre-mature delivery
Birth asphyxia
Day care treatment
Coverage status under ICICI Lombard MaxProtect
New Born Baby Cover is only available in specific conditions under the ICICI Lombard MaxProtect Health Plan
What is AYUSH Treatment?
Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.
Coverage status under ICICI Lombard MaxProtect
Covered Under ICICI Lombard MaxProtect Health Plan up to SI.
What is IVF Treatment?
In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:
Full infertility
No fertility
Infertility diagnosis
Infertility diagnosis and limited fertility treatment
Medication (which may or may not include fertility drug prescriptions)
Coverage status under ICICI Lombard MaxProtect
Not available under ICICI Lombard MaxProtect Health Plan.
What is a Modern Treatment?
Medical treatments that demand the use of modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under ICICI Lombard MaxProtect
Under ICICI Lombard MaxProtect Health Plan modern treatments are covered up to SI.
What is an Ambulance Cover?
An ambulance is used to move the patient from home to the hospital, transfer to another hospital, and take them for different tests outside the hospital.
Coverage status under ICICI Lombard MaxProtect
Covered up to INR 10,000 under ICICI Lombard MaxProtect Health Plan.
What is an Air Ambulance?
Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.
Coverage status under ICICI Lombard MaxProtect
Air Ambulance is covered under ICICI Lombard MaxProtect Health Plan
Not covered for the Classic variant of the plan
Up to the sum insured under the Premium plan variant
What is Compassionate Travel?
Refers to the traveling expenses of a family member of the insured person in case the policyholder gets admitted to a hospital outside his/her residential city.
Coverage status under ICICI Lombard MaxProtect
Under ICICI Lombard MaxProtect Health Plan compassionate travel is not available
What is Global Coverage?
Any kind of medical/health emergency when you are outside of India.
Coverage status under ICICI Lombard MaxProtect
Under ICICI Lombard MaxProtect Health Plan Global treatment is available
Not covered under the Classic variant of the plan
Covered Up to SI at a maximum of up to INR 3 Crore under the Premium variant of the plan
What is E-Consultation?
If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.
Coverage status under ICICI Lombard MaxProtect
ICICI Lombard MaxProtect Health Plan provides unlimited e-consultation for both of the variants (Classic and Premium) under this plan.
What is a Health Checkup?
A facility where the policyholder can avail of free health check-ups after fulfilling the company's policies.
Coverage status under ICICI Lombard MaxProtect
Under the ICICI Lombard MaxProtect Health Plan:-
Not covered in the Classic plan
Covered for Premium MaxProtect plan up to INR 10,000 per policy
What is a Second Medical Opinion?
If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company's network of medical practitioners.
Coverage status under ICICI Lombard MaxProtect
Under the ICICI Lombard MaxProtect Health Plan, an unlimited second opinion is available for critical illness.
What is Vaccination cover?
Coverage against the expenses incurred on vaccinations is provided by the insurance companies.
Coverage status under ICICI Lombard MaxProtect
Not covered
What is Co-payment?
In the co-payment clause, policyholders have to pay a portion of the hospitalization expense on their own and the insurer will pay the rest of the amount.
Coverage status under ICICI Lombard MaxProtect
Applicable, voluntary co-payment.
What is the Sub limit?
Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder.
Coverage status under ICICI Lombard MaxProtect
Applicable
Additional Benefits Offered By ICICI Lombard MaxProtect Plan
This plan gives coverage for Bariatric surgery
Claim Protector available in the Premium variant
Reset SI is applicable
* Bariatric surgery is covered in specification with the doctor's mandate. For further reference, refer to the policy wordings of ICICI Lombard MaxProtect Health Insurance Plan.
What is not covered (Exclusions) under ICICI Lombard MaxProtect Health Insurance
This policy schedule has some exclusions that are mentioned below:
Pre-existing conditions are covered only after the 48th month of the waiting period. It can be reduced to 24 months with a pre-existing disease waiver rider
Daycare procedures like cataract treatment, hernia, varicose veins, etc are covered after a 24-month waiting period
Any kind of external congenital illnesses like cosmetic/beautification/plastic surgery, etc
Breach of the law, alcoholism, drug, or substance abuse cases, etc
Unproven treatments, rest care, rehabilitation, etc
Sterility and infertility, birth control, gender change treatments, etc
Maternity expenses like childbirth (complicated deliveries and caesarean sections, except ectopic pregnancy), miscarriage (except an accident) and lawful medical termination of pregnancy during the policy period
Hypertension, diabetes, cardiac arrests, organ transplants, donor expenses, etc
How to claim ICICI Lombard MaxProtect Health Insurance?
To avail of claim settlement services, the insured individual must follow the process below:-
Visit the official website of ICICI Lombard Health Insurance
Click on the 'Claim' button on the header of the official website.
For claim intimation, the official website has a pre-authorized form that you can fill in with details like name, contact number, email, policy number, city, and product name and click on the Submit' button.
Individuals can call the toll-free number 1800 2666 or SMS 'CLAIM' to 575758 or email their details to customersupport@icilombard.com and get their claim settlement procedure info.
Health insurance ensures your protection against any medical emergencies coming your way. With the 1 crore health plan of ICICI Lombard MaxProtect, you get a large cover with additional benefits. Like global coverage, guaranteed discounts and bonuses, unlimited online consultations in an emergency, and other preventive measures to stay healthy. ICICI Lombard is well-known for its claim settlement record (CSR 2021-22 is 97.7%) and has one of the fastest-responding customer support.
A standard Health plan that offers coverage up to 5 lakhs to the insured & his family. The plan offers you everything you need under a health insurance plan.
Unique Features
Cumulative Bonus
Cataract treatment covered
Modern Procedures covered
Arogya Sanjeevani Policy (Pros)
Intensive Cardiac Care Charges
Ambulance charges up to 2000
Cataract treatment
In-patient hospitalization
Uterine Artery Embolization
Arogya Sanjeevani Policy (Cons)
No Eyesight correction expenses
Fertility expenses not covered
Nursing at home not covered
OPD expenses not covered
No Non-allopathic Treatment
Arogya Sanjeevani Policy (Other Benefits)
Floater benefit
Pre-existing diseases after 4 yrs
In-patient AYUSH treatment
Daycare procedures
Pre and post-hospitalisation
Arogya Sanjeevani Policy (Eligibility Criteria)
Entry Age - 18 Years
Maximum Entry Age - 65 Years
SI - 1 L to 5 L
Waiting Period - 30 Days
Saral Suraksha Plan
ICICI Lombard Saral Suraksha Bima
A plan that offers coverage for accidental death and disablement, temporary total disablement and gives Education Grant.
A versatile health insurance plan with vital features like outpatient treatment coverage, Maternity Benefits, Newborn Baby Cover, and more.
Unique Features
Worldwide cover
Daycare Procedures Covered
OPD cover
Health Shield 360 (Pros)
Wellness Benefits
Pre Hospitalization Cover
Post Hospitalization Cover
Compassionate Visit
No-claim Bonus
Health Shield 360 (Cons)
Obesity/ weight control
Change of gender treatments
Cosmetic or plastic surgery
Hazardous or adventure sports
Breach of law
Health Shield 360 (Other Benefits)
Automatic Restoration
Organ Donor cover
Reset Benefits
Additional sum insured option
Air Ambulance
Health Shield 360 (Eligibility Criteria)
Entry Age - 91 Days
Max Entry Age - 75 Years
SI - 75 L - 1 Crore
Waiting Period - 30 Days
ICICI Lombard MaxProtect Health Plan : FAQ's
1. What are the sum insured options available under ICICI Lombard MaxProtect Health Insurance?
ICICI Lombard MaxProtect Health Insurance plans purely provide coverage according to your requirements. The maximum sum insured under the plan is up to 1 Crore.
2. Do I get maternity coverage with the ICICI Lombard MaxProtect plan?
No, maternity coverage benefits are not included in the plan. However, you can check out health insurance plans with maternity coverage here.
3. Can I buy this plan for my parents who are over the age of 65?
The ICICI Lombard MaxProtect plans are designed for individuals who are below or up to 65 years and not more than that.
4. Which of the additional treatments are covered under ICICI Lombard MaxProtect Health Insurance?
Additional treatments like daycare treatments, modern treatments, AYUSH treatments, and bariatric surgery* are covered.
Simran has an experience of 3 years in insurance content writing. She transitioned from hospitality to the insurance industry after her emerging interest in how vast insurance is. With her ability to write complex insurance concepts in a simple, relatable manner she keeps her audience hooked and solves their doubts smoothly.
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