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 &
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.
60 days post-hospitalization
Named advanced technological surgeries and procedures that require less than 24 hours of
Some of the illnesses that require less than 24 hours hospitalization are:
o Dilatation and curettage
o Cardiac Catheterization
o Lithotripsy (Kidney Stone removal)
o Eye Surgery
o Coronary Angiography
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
orthopedic, maternity, dental, pharmacy, general
practitioner and other medical expenses incurred on OPD
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 medical check- up required upto 55 years for purchase
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
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'.
Any illness/disease/injury existing before the inception
of the policy for the first 2 years.
Any illness contracted during the first 30 days of inception of the policy ,except accidents.
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
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
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
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 # #
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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