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Complete Health Insurance
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Existing plan: Family Protect Premier USP - No Sub limits No co-payments Floater / Individual 1 yr/ 2 year Plans Hospital Daily Cash Convalescence benefit of Rs 10,000 per insured per year 3500+ hospital network Tax benefit under section 80D Hospitalization and day care covered All declared pre existing diseases covered after 4 years
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What does a customer want ? A Complete package Flexibility to choose coverage under single policy Sum insured range Selective covers (like Maternity and OPD) Optional Add-on covers (Nursing, CI, PA, Donor expenses, Compassionate visit) Affordable premium Option to reduce premium (by applying Sub Limit) Plan with more features & benefits Maximum renewability : Life long PED coverage : 2 / 4 years Floater & Individual options Value added services
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Complete Health Insurance (CHI) Optional Covers Nursing + Compassionate Visit Mandatory Cover Select Covers Key Features Hospital daily cash + Convalescence Benefit Hospital daily cash + Convalescence Benefit Maternity + OPD Critical Illness + Donor + Personal accident Critical Illness + Donor + Personal accident Basic Hospitalization + Ambulance cover Basic Hospitalization + Ambulance cover Wide Range of Sum Insured (1 – 50 Lacs) Wide Range of Sum Insured (1 – 50 Lacs) PED: 2 yr & 4 yr (As per plan) PED: 2 yr & 4 yr (As per plan) Flexi Option: Opt for Sub-limits as per plan Flexi Option: Opt for Sub-limits as per plan Lifetime renewability
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Complete Health Insurance v/s FPP/Old CHI Features OLD CHI (Comprehensive health insurance) FPP (Family Protect Premier) Complete Health Insurance Maximum Entry Age60No Limit Renewability8070Lifetime Tenure1 or 2 Year Hospital Daily CashNoYesOptional ConvalescenceYesOptional PEDs Waiting Period4 Years2 or 4 years (as per plan) Domestic Road Emergency AmbulanceNoYes Maternity CoverNo In Select plans Baby cover from date of birthNo OPD + Wellness & Preventive CareNo Critical Illness + PA + Donor ExpNoOptional Health check upYes Value Added ServiceNoYes Optional Add OnsNoYes Sublimit OptionsNoAvailable
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Product in detail
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CHI : Sum Insured options New CHI comes with Flexibility to choose Sum Insured Every customer is different and so is his health cover need Under CHI Sum insured starts at as low as 1 lac and goes up to 50 Lacs Now choice of sum insured is with the customer Offer a plan from CHI that best suits required sum insured Most of the PSU and PVT insurance company offer highest sum insured only upto 10 lacs Sum insured1 & 2 Lacs3,4 & 5 Lacs7 & 10 Lacs 15, 20, 30 & 50 Lacs CHI plan Individual HealthHealth ProtectHealth SmartHealth Smart Plus Health SecureHealth Protect Plus Health Secure Plus So next time you come across a customer who wants sum insured of his choice, offer him ICICI Lombard NEW CHI
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CHI : Select covers Flexibility to choose coverage Select covers : Customer can choose a plan with inbuilt maternity & OPD cover So if a customer wants 5 lacs sum insured with Maternity & OPD : Offer Health Protect Plus If a customer wants 5 lacs sum insured without Maternity & OPD : Offer Health Protect Sum insuredCHI plan Inbuilt Maternity & OPD cover 1 & 2 LacsIndividual HealthNo 1 & 2 LacsHealth SecureNo 1 & 2 LacsHealth Secure PlusYes 3,4 & 5 LacsHealth ProtectNo 3,4 & 5 LacsHealth Protect PlusYes 7 & 10 LacsHealth SmartYes 15, 20, 30 & 50 LacsHealth Smart PlusYes You can now ask the customer whether he wants a plan with Maternity & OPD option or only basic hospitalization without Maternity & OPD * Maternity is only applicable in 2 Adults, 2A 1C, 2A 2C, 2A 3C (Only for Spouse)
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CHI : Optional Covers Flexibility to choose coverage Optional covers : Customer can choose optional add on covers in addition to hospitalization Customer can choose to have optional cover by paying additional premium applicable to the cover Also these options have been designed so that customer has complete flexibility and choice CHI planMandatory CoversOptional Covers Individual Health 1 & 2 LacsHospitalization & Ambulance Hospital daily cash (HDC) & Convalescence Health Secure 1 & 2 LacsHospitalization & AmbulanceHospital daily cash & Convalescence Health Secure Plus 1 & 2 LacsHospitalization, Ambulance, Maternity & OPDHospital daily cash & Convalescence Health Protect 3,4 & 5 LacsHospitalization & AmbulanceHospital daily cash & Convalescence Health Protect Plus 3,4 & 5 Lacs Hospitalization, Ambulance, Maternity, OPD, HDC (Hospital Daily cash) & Convalescence Critical Illness + Donor Expenses + Personal accident cover Health Smart 7 & 10 Lacs Hospitalization, Ambulance, Maternity, OPD, HDC & Convalescence 1) Critical Illness + Donor Expenses + Personal accident cover 2) Nursing & Compassionate Visit Health Smart Plus 15, 20, 30 & 50 Lacs Hospitalization, Ambulance, Maternity, OPD, HDC, Convalescence, Nursing & Compassionate Visit Medical Evacuation Critical Illness + Donor Expenses + Personal accident cover
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Surgeries / Medical ProceduresA*B*C** Cataract per eye10,00015,00020,000 Other Eye Surgeries15,00022,00035,000 ENT15,00022,00035,000 Surgeries for - Tumors/Cysts/Nodule/Polyp20,00030,00060,000 Stone in Urinary System20,00030,00040,000 Hernia Related20,00030,00060,000 Appendisectomy20,00030,00040,000 Knee Ligament Reconstruction Surgery40,00060,00090,000 Hysterectomy20,00030,00060,000 Fissures/Piles/Fistulas15,00022,00035,000 Spine & Vertebrae related40,00060,00090,000 Cellulites/Abscess15,00022,00035,000 Other Surgeries & Procedures25,00037,00055,000 All Medical Expenses for any treatment not involving surgery/medical procedure 10,00015,00025,000 *Sub-limits A & B shall be applicable for Annual Sum Insured options up to Rs. 2 lacs **Sub-limits C shall be applicable for Annual Sum Insured Rs. 3 lacs. 4 lacs and 5 lacs Sublimit On.... Complete Health Insurance also provides the option of sub-limits under specific plans Sub-limit defines the capping of insurance amount for specific surgeries and medical procedures. Thus the premium of a plan with sub-limits is lower.
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Sub limits Any complications resulting from or arising out of any surgery or medical procedure shall be subject to the overall Sub-limit, as applicable No Sub-limits shall be applicable on any Major Medical Illness & Procedures and Joint Replacement Surgery. Major Medical Illness & Procedures for the purpose of this Policy shall mean and include the following: Cancer End Stage Renal Failure Major Organ Transplant All cardiac surgeries / conditions including but not limited to Heart Valve Replacement, Coronary Artery Bypass Graft (CABG) and Myocardial Infarction Multiple Sclerosis Stroke Paralysis All brain related surgeries Back
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Value Added Services Back Plan NameVAS Health SecureV1 Health Secure PlusV1 Health ProtectV2+ V4 Health Protect PlusV2+ V4 Health SmartV3+ V4 Health Smart PlusV3+ V4 iHealth PlusV2+ V4 Value-Added Service (VAS) Constructs V1 Free Health check-up (T1) Online Chat with doctor V2 Free Health check-up (T2) Online Chat with doctor Specialist e-Consultation with One Follow-up session Dietician & Nutritionist e-Consultation V3 Free Health check-up (T3) Online Chat with doctor Specialist e-Consultation with One Follow-up session Dietician & Nutritionist e-Consultation Physiotherapy, Speech & Audiologist e- Consultation Vaccination Care (Hepatitis A & B) V4Discount Coupons
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Individual Health Insurance Annual Sum Insured : 1 and 2 lacs Basic cover: Hospitalization & Ambulance cover Optional cover: Hospital daily cash & Convalescence benefit * Only applicable for renewals Eligibility: Minimum Entry Age Maximum Entry Age 6 years No Maximum Entry Age Exit AgeNo Exit Age Mandatory Medical check-upAfter 45 years Waiting Period for Pre-existing Illness4 years Floater optionNot Applicable Policy Tenure1 Year / 2 Years Applicability of Sub-limitSub limit A and B; No sub-limit option available only for 2 lac Mandatory Add-onDomestic Road Emergency Ambulance Optional Add-ons1)Hospital Daily Cash (for max. 10 days, min 3days): Rs 500 per day 2)Convalescence Benefit: Rs 10000 (Flat) Value Added ServicesNot Applicable
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Health Secure Annual Sum Insured : 1 and 2 lacs Basic cover: Hospitalization & Ambulance cover Optional cover: Hospital daily cash & Convalescence benefit Eligibility: Minimum Entry Age Maximum Entry Age Kids from 3 months No Maximum Entry Age Exit AgeNo Exit Age Mandatory Medical check-upAfter 45 years Waiting Period for Pre-existing Illness4 years Floater optionOnly Floater Cover Policy Tenure1 Year / 2 Years Applicability of Sub-limitSublimit A and B; No sub-limit option available only for 2 lac Mandatory Add-onDomestic Road Emergency Ambulance Optional Add-ons1)Hospital Daily Cash (for max. 10 days, min 3 days) :Rs 500 per day 2) Convalescence Benefit: Rs 10000 (Flat) Value Added ServicesFree Health check-up (T1) & Online chat with doctor
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Health Secure Plus Annual Sum Insured : 1 and 2 lacs Basic cover: Hospitalization, Ambulance cover, Maternity Benefit & Outpatient Treatment Cover (OPD) Optional cover: Hospital daily cash & Convalescence benefit Eligibility: Minimum Entry Age Maximum Entry Age 6 years; (Kids from 3 months - 5 years covered only under Floater options) No Maximum Entry Age Exit AgeNo Exit Age Mandatory Medical check-upAfter 45 years Waiting Period for PED4 years Floater optionYes Policy Tenure1 Year / 2 Years Applicability of Sub-limitSublimit A and B; No sub-limit option available only for 2 lac Mandatory Add-on 1)Domestic Road Emergency Ambulance 2)Maternity Benefit (Normal + caesarian delivery / Pre-Post Natal (2000 each) / New Born Baby (10,000)) - 3 Yrs WP: Normal 10K, caesarian 15K 3)Outpatient Treatment Cover + Wellness & Preventive Healthcare : Rs 2500 (Floater) Optional Add-ons 1)Hospital Daily Cash (for max. 10 days, min 3 days) :Rs 500 per day 2)Convalescence Benefit: Rs 10000 (Flat) Value Added ServicesFree Health check-up (T1) & Online chat with doctor
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Health Protect Annual Sum Insured : 3,4 and 5 lacs Basic cover: Hospitalization & Ambulance cover Optional cover: Hospital daily cash & Convalescence benefit Eligibility: Minimum Entry Age Maximum Entry Age 6 years; (Kids from 3 months - 5 years covered only under Floater options) No Maximum Entry Age Exit AgeNo Exit Age Mandatory Medical check-upAfter 45 years Waiting Period for Pre-existing Illness2 years Floater optionYes Policy Tenure1 Year / 2 Years Applicability of Sub-limitSublimit C; No sub-limit options also available for all Annual SI options Mandatory Add-onDomestic Road Emergency Ambulance Optional Add-ons1) Hospital Daily Cash (for max. 10 days, min 3 days): Rs 1000 per day 2) Convalescence Benefit: Rs 10000 (Flat) Value Added ServicesFree Health check-up (T1) & Online chat with doctor, specialist consultation, dietician & nutritionist consultation, Discount coupon book
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Health Protect Plus Annual Sum Insured : 3,4 and 5 lacs Basic cover: Hospitalization, Ambulance cover, Hospital daily cash, Convalescence benefit, Maternity benefit & OPD Optional cover: CI, PA & Donor expenses Eligibility: Minimum Entry Age Maximum Entry Age 6 years; Kids from 3 months - 5 years covered only under Floater options No Maximum Entry Age Exit AgeNo Exit Age Mandatory Medical check-upAfter 45 years Waiting Period for Pre-existing Illness2 years Floater optionYes Policy Tenure1 Year / 2 Years Applicability of Sub-limitNot Applicable Mandatory Add-on1)Domestic Road Emergency Ambulance 2)Hospital Daily Cash (for max. 10 days, min 3 days): Rs 1000 per day 3)Convalescence Benefit: Rs 10000 (Flat) 4)Maternity Benefit (Normal + caesarian delivery / Pre-Post Natal (2000 each) / New Born Baby (10,000)) - 3 Yrs WP: Normal 15K, caesarian 25K 5)Outpatient Treatment Cover + Wellness & Preventive Healthcare: Rs 5000 (Floater) Optional Add-onsCritical Illness & PA (upto sum insured per member, Max 2 Adults) Donor expenses : Rs 50000 (per member, Max 2 adults) Value Added ServicesFree Health check-up (T1) & Online chat with doctor, specialist consultation, dietician & nutritionist consultation, Discount coupon book
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Health Smart Annual Sum Insured : 7 and 10 lacs Basic cover: Hospitalization, Ambulance cover, Hospital daily cash, Convalescence benefit, Maternity benefit & OPD Optional cover: CI, PA & Donor expenses, Nursing & Compassionate visit Eligibility: Minimum Entry Age Maximum Entry Age 6 years; Kids from 3 months - 5 years covered only under Floater options No Maximum Entry Age Exit AgeNo Exit Age Mandatory Medical check-upAfter 45 years Waiting Period for Pre-existing Illness2 years Floater optionYes Policy Tenure1 Year / 2 Years Applicability of Sub-limitNot Applicable Mandatory Add-on1)Domestic Road Emergency Ambulance 2)Hospital Daily Cash (for max. 10 days, min 3days): Rs 2000 per day 3)Convalescence Benefit: Rs 10000 (Flat) 4)Maternity Benefit (Normal + caesarian delivery / Pre-Post Natal (2000 each) / New Born Baby (10,000)) - 3 Yrs WP: Normal 25K, caesarian 50K 5)Outpatient Treatment Cover + Wellness & Preventive Healthcare: Rs 10000 (Floater) Optional Add-ons1)Nursing at home ( max 15 days) : Rs 3000 per day 2)Compassionate visit : upto Rs 20000 3)Critical Illness & PA (upto sum insured per member, Max 2 Adults) 4)Donor expenses : Rs 50000 (per member, Max 2 adults) Value Added ServicesFree Health check-up (T3) & Online chat, Super specialist consultation, dietician & nutritionist consultation, Physiotherapy, speech & audiologist consultation Discount coupon book
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Health Smart Plus Annual Sum Insured : 15, 20, 30 and 50 lacs Basic cover: Hospitalization, Ambulance cover, Hospital daily cash, Convalescence benefit, Maternity benefit, OPD, Nursing & Compassionate visit Optional cover: CI, PA & Donor expenses Eligibility: Minimum Entry Age Maximum Entry Age 6 years; Kids from 3 months - 5 years covered only under Floater options No Maximum Entry Age Exit AgeNo Exit Age Mandatory Medical check-up All insured above 45 years age Senior most member, irrespective of age, if Annual Sum Insured greater than 10 lacs Waiting Period for PED2 years Annual Sum Insured availableINR 15 Lac / 20 Lac / 30 Lac / 50 Lac Policy Tenure1 Year / 2 Years Applicability of Sub-limitNot Applicable Mandatory Add-on 1)Domestic Road Emergency Ambulance 2)Hospital Daily Cash (for max. 10 days, min 3 days): Rs 3000 per day 3)Convalescence Benefit: Rs 10000 (Flat) 4)Maternity Benefit (Normal + caesarian delivery / Pre-Post Natal (2000 each) / New Born Baby (100,000)) - 3 Yrs WP: Normal 25K, caesarian 50K 5)Outpatient Treatment Cover + Wellness & Preventive Healthcare: Rs 20000 (Floater) 6)Nursing at home ( max 15 days) : Rs 3000 per day 7)Compassionate visit : upto Rs 20000 8)Medical Evacuation Cover Optional Add-ons 1)Critical Illness & PA (50% of policy sum insured per member, Max 2 Adults) 2)Donor expenses : Rs 50000 (per member, Max 2 adults) Value Added Services Free Health check-up (T3) & Online chat, Super specialist consultation, dietician & nutritionist consultation, Physiotherapy, speech & audiologist consultation Discount coupon book
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Covers Cover type: Floater / Individual Applicable to all or specific Insured No of times it can be claimed in a policy period Does it get restored after 1 year for 2 year policy Is it included in policy SI or over an above SI Hospital Daily Cash (for max. 10 days, min 3 days) Per member AllOnceYes Over & Above Basic Policy SI Convalescence Benefit Per member AllOnceYes Over & Above Basic Policy SI Maternity Benefit (Normal + Cesarean delivery / Pre-Post Natal / New Born Baby ) - 3 Yrs WP Floater basis only to Spouse Only in 2 A, 2A 1C, 2A 2C, 2A 3C (Only for Spouse) Upto 2 deliveries during lifetime of policy Yes But only upto 2 deliveries Over & Above Basic Policy SI Nursing at Home Per member AllOnceYes Over & Above Basic Policy SI Compassionate Visit Per member AllOnceYes Over & Above Basic Policy SI Outpatient Treatment Cover + Wellness & PHC Floater basis AllOnceYes Over & Above Basic Policy SI Critical Illness Cover Individual Max. for 2 Adults OnceNo Over & Above Basic Policy SI Donor Expenses Individual Max. for 2 Adults All Events upto Donor Expenses SI No Over & Above Basic Policy SI Personal Accident Individual Max. for 2 Adults OnceNo Over & Above Basic Policy SI Medical Evacuation Cover Per member AllOnceYes Over & Above Basic Policy SI Domestic Road Emergency Ambulance Cover Per member AllPer IncidentYes Over & Above Basic Policy SI
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Complete Health Insurance: Key Features Summary
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Thank you
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