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Personal Health
Insurance from
ICICI Lombard

Call +91 9900113820 for
more information
Who said I need health Insurance?
I don’t fall sick!! Why
should I take an Health
Insurance??
Why Health Insurance?
Health insurance is needed more now than ever
before because of -

Skyrocketing
medical costs

Need ...
Benefits of Health Insurance from ICICI Lombard
Day care surgeries
/ treatments
covered
Free yearly medical
checkup coupon...
Scope/ Coverage
What illness will you be
covered for ?? And what
will you not be covered !
Scope of cover


Disease/ Injury




Treated medically/
surgically
By Hospitalisation/
Domiciliary hospitalisation
At ...
Compensation payable


Reasonable and
necessarily incurred




Room expenses in
hospital/ nursing home
Nursing expense...
Compensation payable contd.…





Pre and post
hospitalisation expenses
Max of SI
Surgical operation
Manual operative
...
Hospitalisation



Min period of 24 hrs
Time limit not applicable for specific treatment







Dialysis
Chemothera...
Pre & post hospitalisation


Pre hospitalisation




Post hospitalisation




Relevant medical expenses 30 days prior...
Domiciliary hospitalization





Treatment exceeding 3 days at
Residence
 Serious condition of patient does
not allow ...
My No Service Areas..
Ok.. Lot of things are
covered…Is there
anything left that we don’t
cover???
First year exclusions
Cataract
Benign prostratic
hypertrophy
Hysterectomy for
menonhargia or fibromyoma
Hernia/ hydrocele
...
General exclusions









War/ war group
Nuclear perils
Plastic surgery
Spectacles/ contact lens/
hearing aid
De...
General exclusions contd.…


Use of intoxicating drugs/
alcohol
 Aids
 Diagnostic/ laboratory
expenses not consistent
w...
Mediclaim…No Money
What if you have an
emergency. Can we
provide service without
cash??
Cashless mediclaim


Claim handled by both ICICI Lombard Health care
& Outside TPA depending upon Client
 Planned treatm...
Reimbursement
Process of
Reimbursement and
claims is giving me
Nausea.. I think I am sick..
Reimbursement – mediclaim


Planned / Emergency treatment in
non-notified hospital
 Notice to TPA & approved
 Submit

...
Thank you

Call +91 9900113820 for more
information
Complete health insurance policy (individual) from icici lombard
Complete health insurance policy (individual) from icici lombard
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Complete health insurance policy (individual) from icici lombard

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This presentation explains about the various features and benefits of availing Individual health insurance policy (for self and family) from ICICI Lombard.

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Transcript of "Complete health insurance policy (individual) from icici lombard"

  1. 1. Personal Health Insurance from ICICI Lombard Call +91 9900113820 for more information
  2. 2. Who said I need health Insurance? I don’t fall sick!! Why should I take an Health Insurance??
  3. 3. Why Health Insurance? Health insurance is needed more now than ever before because of - Skyrocketing medical costs Need for routine medical check ups and care Expensive trips to specialist doctors Possibility of hospitalization and treatment
  4. 4. Benefits of Health Insurance from ICICI Lombard Day care surgeries / treatments covered Free yearly medical checkup coupons for up to 2 people Optional Maternity cover available Cashless Treatment at Specialty Hospitals Pre-existing disease covered (after 2 years) Outpatient treatment covered
  5. 5. Scope/ Coverage What illness will you be covered for ?? And what will you not be covered !
  6. 6. Scope of cover  Disease/ Injury    Treated medically/ surgically By Hospitalisation/ Domiciliary hospitalisation At Nursing home/ hospital in India as in-patient  Pre hospitalisation   Post hospitalisation   Age limit  90 days – 80 years Relevant medical expenses 30 days prior to hospitalisation Relevant medical expenses 60 days after hospitalisation
  7. 7. Compensation payable  Reasonable and necessarily incurred    Room expenses in hospital/ nursing home Nursing expenses Medical practitioner fee  Treatment cost       Medicines/ diagnostic cost Blood/ oxygen Cost of pacemaker Operation theatre charges Surgical appliances Dialysis, chemotherapy, radiotherapy
  8. 8. Compensation payable contd.…     Pre and post hospitalisation expenses Max of SI Surgical operation Manual operative procedure for  Deformity  Defect correction  Diagnosis cure  Prolongation of life
  9. 9. Hospitalisation   Min period of 24 hrs Time limit not applicable for specific treatment      Dialysis Chemotherapy Tonsillectomy Day Care Cataract
  10. 10. Pre & post hospitalisation  Pre hospitalisation   Post hospitalisation   Relevant medical expenses 30 days prior to hospitalisation Relevant medical expenses 60 days after hospitalisation Any one illness  Continuous Period of Illness  Relapse within 45 days of the earlier treatment
  11. 11. Domiciliary hospitalization    Treatment exceeding 3 days at Residence  Serious condition of patient does not allow removal to hospital  Lack of accommodation in nursing home Pre / post hospitalisation expenses not covered Specified diseases excluded Asthma/ Diabetes/ Dysentery/ Hypertension/ Flu/ Epilepsy/ Arthritis
  12. 12. My No Service Areas.. Ok.. Lot of things are covered…Is there anything left that we don’t cover???
  13. 13. First year exclusions Cataract Benign prostratic hypertrophy Hysterectomy for menonhargia or fibromyoma Hernia/ hydrocele Congenital internal disease Fistula in anus/ piles Sinusitis & related disorder
  14. 14. General exclusions         War/ war group Nuclear perils Plastic surgery Spectacles/ contact lens/ hearing aid Dental treatment Convalescence/ general debility Sterility/ venereal disease / circumcision Intentional self injury
  15. 15. General exclusions contd.…  Use of intoxicating drugs/ alcohol  Aids  Diagnostic/ laboratory expenses not consistent with treatment  Vitamins/ tonic inconsistent with treatment  Pregnancy  Naturopathy
  16. 16. Mediclaim…No Money What if you have an emergency. Can we provide service without cash??
  17. 17. Cashless mediclaim  Claim handled by both ICICI Lombard Health care & Outside TPA depending upon Client  Planned treatment in notified hospital  Inform TPA & get treatment post approval  Cashless / Hassle free claims settlement  Emergency – What to do???  Give TPA membership no  Intimate TPA & approval  Cashless / Hassle free claims settlement
  18. 18. Reimbursement Process of Reimbursement and claims is giving me Nausea.. I think I am sick..
  19. 19. Reimbursement – mediclaim  Planned / Emergency treatment in non-notified hospital  Notice to TPA & approved  Submit  Duly completed claim form  Bills, receipts and discharge certificate/card from the Hospital  Bills from Chemists supported by proper prescription.  Test reports and payment receipts  Settlement within a week on complete submission
  20. 20. Thank you Call +91 9900113820 for more information
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