icicI Lombard health adv

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					Dear Sir,

Life is full of surprises… some bitter, some sweet. Health and wellness form an important aspect
of the balance in your life. To ensure that you are taken care of when the need arises, we present
'Health Advantage Plus', a unique innovative health Insurance plan that cover much more than
basic hospitalization covers. It covers medical emergencies like surgeries, accidents and sudden
illnesses,dental treatment expenses. You can avail a full utilization of tax benefit on up to
Rs.15,000/- (Rs.20,000 for Senior Citizens) under Section 80D of the Income Tax Act 1961 &
amendments thereof.


                                    Health Advantage Plus -Coverages


        Basic Hospitalization       Covers all reasonable and necessary medical expenses
              Cover for             incurred durins hospitalization for more than 24 hours, subject
              Benefit A             to sum insured under benefit A.

        30days pre-hospitalization
        60 days post-hospitalization
        Named advanced technological surgeries and procedures that require less than 24 hours of
         hospitalization ~.
        Some of the illnesses that require less than 24 hours hospitalization are:
             o Cataract
             o Dilatation and curettage
             o Cardiac Catheterization
             o Lithotripsy (Kidney Stone removal)
             o Chemotherapy
             o Tonsillectomy
             o Radiotherapy
               o    Eye Surgery
               o    Coronary Angiography
               o    Dialysis

          ~Conditions Apply


         Pre-existing Diseases- It will be covered after the 2nd year, on continuous renewal with
          'Health Advantage Plus'


                                   For the first time in India, you can avail of an insurance cover for
         Outpatient Treatment
                                   orthopedic, maternity, dental, pharmacy, general
            Expenses for
                                   practitioner and other medical expenses incurred on OPD
              Benefit B
                                   basis.
This is an insurance cover to cover expense that you incur for your health,subject to sum insured
under benefit B.
The Outpatient Treatment Expenses can be claimed only once a year within a period of 90 days
from the start of cover and 30 days from the end of cover.




                                               Floater is a common cover for both the members

            Floater Cover               Anyone out of the 2 adults insured can avail of cover under
                                        benefit A and B of Health Advantage Plus; Floater provides a
                                        common cover for both members.
Suppose Mr.& Mrs. Kumar take a 3 lacs(Benefit A) cover. In an foreseen situation wherein a
surgery and post hospitalization bill for Mr.Kumar amounts to Rs.1.9 lacs, the remaining 1.1 lacs
can be claimed by Mrs. Kumar or even Mr. Kumar later. If Mr. & Mrs. Kumar had taken two
separate policies of 1.5 lacs each then Mr. Kumar would have to pay 0.4 lacs from his own pocket.
With floater thecover of3 lacs would be shared among both Mr. & Mrs. Kumar; thus making
available to both of them a cover of 3lacs.
                  No
                                               No medical check- up required upto 55 years for purchase
                Medical
                                               of policy.
                Checkup


                                               Simply use your 'Health Advantage Plus' ID card at any of the
             Cashless                          4000+ hospitals and avail of cashless service, a boon for
           Hospitalization                     those times when you need finance the most. This benefit is
                                               only for hospitalization claims.


                                               You can avail a full utilization of tax benefit on upto
               Maximum                         Rs.15,000/- (Rs.20,000 for Senior Citizens) as premium paid
              Tax Benefit                      under Section 80D of the Income Tax Act,1961. This will save
                                               upto Rs.5,099/- ^ in your tax liability in one year.
^ Indicative figure. Please consult your Tax Advisor for Tax benefits, under section 80D, applicable to you.


             Pre-existing                      Pre-existing diseases covered from the third year
               Disease                         onwards upon two consecutive renewals
                                                                  Eligibility


The proposer has to be aged above 18 years. The age of entry for the senior most members
proposed for insurance is 65 years and the cover is renewable till the insured person reaches
70 years of age.

The proposer can cover any two members. Self, spouse,dependent parents and children, aged
between 5 yrs to 65 yrs, to avail of benefit under 'Health advantage Plus'.


                                                                 Exclusions



                                                           Any illness/disease/injury existing before the inception
          Exclusion-Under
                                                            of the policy for the first 2 years.
             Benefit-A

         Any illness contracted during the first 30 days of inception of the policy ,except accidents.
         Congenital disease
         Non-allopathic treatment, Expenses arising from HIV or AIDS and related diseases, use or
          misuse of liquor, intoxicating substances or drugs as well as international self injury!
         War, riot, strike, nuclear weapons induced hospitalization!
         Certain ailments will be excluded from treatment for 2-years: Cataract; Benign Prostatic
          Hypertrophy; Myomectomy, Endometriosis, Hysterectomy unless because of malignancy;
          All types of Hernia, Hydrocele; Fissures &/or Fistula in anus, haemorrhoids/piles; Arthritis,
          gout, rheumatism and spinal disorders; Joint replacements unless due to accident; Sinusitis
          and related disorders; Stones in the urinary and biliary systems; Dilatation and curettage;
          All types of Skin and internal tumours/cysts/nodules/polyps of any kind including breast
          lumps unless maligant; Dialysis required for chronic renal failure; Surgery on tonsils,
          adenoids and sinuses; Gastric and Duodenal uclers; Deviated Nasal Septum 1

! Also excluded under benefit B
1
  this is only an indicative list. For complete list refer to Policy wording

           Exclusion-Under                        The Company shall not receive any claims prior to completion
              Benefit-B                           of 90 days of the commencement of the Policy.


                                                    How Do I Claim My Insurance



The claims for Health Advantage Plus are serviced by TPA (TTK Healthcare Services Pvt. Ltd.). We
constantly measure the TPA on set parameters to ensure the most responsive and best of services
to our valued customers.

In case of emergency or planned hospitalisation, just use your Health ID Card at TTKs network
hospitals and avail of cashless service. Call TTKs 24-hour-toll-free number 1800-425-8874/1800-
425-8854/1800-425-8885 for complete health assistance.

For treatment in non-network hospitals: The claim form must be filled fully after discharge from
hospital and sent to TTK office along with the following documents in original >.

         Hospital Bill with Receipt for payment, the receipt should be stamped and preferably
          numbered.
         Doctors prescription and medicine bills.
         Discharge summary from the hospital.
         Pathological reports and other investigation reports along with the doctor's authorization.
         All other relevant details and documents connected to hospitalization.

Claim for OPD will also be handled by the TPA (TTK Healthcare Services). For these claims to be
processed, medical prescription is a mandatory requirement.

> Expenses relating to hospitalization will be reimbursed under Benefit A & OPD expenses under Benefit B


No claim shall be admissible under this Benefit B, 30days after expiry of the Period of
Insurance.


                                                              Premium Grid




                                                                   5-60 yrs.                         61-70 yrs.
Premium (including Taxes and Cess) - Fixed                       Rs.15,000/-                         Rs.20,000/-


                                                        Choose he Plan Option




                                                      Individual                       2 Adults with Floater Benefit
     Age of Senior Most                    SI under               SI under               SI under            SI under
          Member                            Benefit                Benefit                Benefit             Benefit
                                           A= 2Lacs               A= 3Lacs               A= 2Lacs            A= 3Lacs

                                       SI under Benefit B as below                   SI under Benefit B as below

         5 yrs. - 18 yrs.                   10,000                   9,500                     #                   #
         19 yrs. - 35 yrs.                   9,000                   8,800                  8,000                 7,500
         36 yrs. - 45 yrs.                   8,500                   8,000                  7,000                 6,500
         46 yrs. - 55 yrs.                   6,000                   5,500                  3,000                 2,000
         56 yrs. - 60 yrs.                   4,500                   3,500                     #                   #
         61 yrs. - 65 yrs.                   7,000                   5,500                     #                   #
         66 yrs. - 70 yrs.                   4,000                   2,000                     #                   #


Note :

1) *Individual (s) proposed for insurance whose age is 56 years and above have to compulsorily
   undergo medical tests at ICICI Lombard designated diagnostic centers

2) Age is in completed years as on last birthday
  3) 65 years is the maximum age of entry for this product, renewable upto the age of 70 years

  4) The maximum benefit available under each plan shall be as per the sum insured mentioned
  against each section.

  5) #-Plan not available




                                  You can also Buy Insurance over the phone
                                  Call us Now !
                                  Toll Free: 1800-209-8888 (Accessible even from your mobile phone)




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Registered Office: ICICI Lombard General Insurance Company Ltd. ICICI Bank Towers, Bandra Kurla Complex, Mumbai - 51.
Mailing Address: ICICI Lombard General Insurance Company Ltd. Zenith House, Keshavrao Khadye Marg, Mahalaxmi, Mumbai - 34.


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