ICICI Lombard
Elevate
- Up to Single Private Room
- 36 months
- Refills 100% of your cover, any number of times a year - all refills in a year together cannot cross 100% of your Sum Insured
The ladder that ends in Unlimited - Sum Insured from ₹5 Lakh upward with an Unlimited option at the top, on policy terms of one to five years.
PLAN SELECTION
1 plan available with 10 sum insured options
All plans
Elevate
What you should know first
At a glance
5 strong5 to watch
What's strong
- Loyalty bonus +20% a year, claim or not - never clawed back.
- 90 days pre-, 180 days post-hospitalisation, both to full cover.
- No day-care list - any short procedure qualifies by its nature.
- Robotic surgery and oral chemotherapy paid to full cover, uncapped.
- Mental health at full parity - no sub-limit, no exclusion.
What to watch
- Pre-existing conditions wait 36 months; the buy-down is day-one only.
- Extra 90-day wait for diabetes, blood pressure and cardiac conditions.
- Reset never funds the year's first claim - one big claim gets no refill.
- Maternity caps at ₹1 lakh whatever your cover, and only at renewal.
- No funded second opinion; OPD is app-cashless only.
The policy in one card
Sum Insured
Room rent
Non-payable items
Waiting periods
Co-pay and deductible
Restoration
Cumulative bonus
Not covered
One year through this plan
Two hospital bills in year one, on ₹10 Lakh of cover.
| Bill | Elevate |
|---|---|
| 1st bill₹7,00,000 | CoveredPaid from Sum Insured ₹7,00,000 |
| 2nd bill₹12,00,000 | CoveredPaid from |
01The ledger
Every feature, decoded
Tell us about your family and health - this list reorders around what matters to you.
Start the 90-second checkBig hospital bills3 of 15 are priority
Your room is covered up to a Single Private AC room, Take a costlier room and your room, nursing, operation theatre and doctor charges are paid on a pro-rata basis. Optional Cover, Room Modifier, removes the room limit or lowers it.
Coverage detailstap any row to understand it
Room cost limitUp to Single Private Room
If you exceed the room limitProportionate deduction on Room + Associated Medical Expenses
Room upgrade riderAvailable - Both
Minimum Hospitalisation Duration to Qualify (Hours)24 hours
Watch out
A Single Private AC room is defined as the hospital's most basic and most economical single room, so a better single room can still count as an upgrade. The room benefit needs an admission of more than 24 hours unless you buy the 2-Hour Hospitalization option.
The consumables a hospital bills you for - gloves, kits, electrodes and the rest of Annexure II List I - are not paid by the base cover. Optional Cover, Claim Protector, makes that whole list payable when an in-patient or day-care claim is accepted. No Loyalty Bonus, Inflation Protector or Reset amount can be used for it.
Coverage detailstap any row to understand it
How it's coveredOptional add-on
IRDAI Non-payable Lists CoveredList I
Reduces Main Sum InsuredYes
Expense limitCovered up to full Sum Insured
Watch out
Claim Protector works only inside India, even if you also buy Worldwide Cover. The non-payable list itself can be updated by IRDAI, so check the current list on the insurer's website before a planned admission.
Follow-up expenses for the 180 days after you are discharged are covered up to your full Sum Insured, with no separate limit. Physiotherapy can be included when it is medically necessary and prescribed by the treating doctor. Like the pre-hospitalisation benefit, it pays only if the claim was accepted.
Coverage detailstap any row to understand it
Coverage Days After Discharge180 days
Expense limitCovered up to full Sum Insured
Day-Extension Rider AvailableNo
Claim Settlement TypeReimbursement Only
Watch out
The wording says physiotherapy may be considered, so keep the doctor's written prescription with the bills. Expenses linked to a claim under the Optional Covers section are not paid under this benefit.
Cancer & serious illness4 of 10 are priority
Once a claim has been paid in the year, later bills can draw up to 100% of your Sum Insured again, any number of times, for the same illness or a new one. Two limits set its real size: the first claim of each year never gets it, and a year's resets cannot cross 100% of Sum Insured.
Coverage detailstap any row to understand it
How it's coveredIncluded in the base plan
What the insurer calls itReset Benefit
RefillsRefills 100% of your cover, any number of times a year - all refills in a year together cannot cross 100% of your Sum Insured
Illnesses eligible for refillCan be used for the same illness or a new one
Activates FromAfter First Paid Claim
Watch out
The first claim of a policy year never gets the reset, so one large bill early in the year is paid only from your Sum Insured and accrued bonus. If you buy the Vital Essence add-on, the reset drops from unlimited times to once a year.
Elevate funds no separate pool above your Sum Insured. Cover beyond it comes from the Reset Benefit: one claim is paid from your Sum Insured, then the bonuses, then up to 100% of your Sum Insured in reset money, so a single bill can be paid past what you bought. The first claim of each policy year gets none of it.
Coverage detailstap any row to understand it
How it's coveredIncluded in the base plan
What the insurer calls itReset Benefit
Extra coverAdds up to 100% of your cover extra on each claim, as a refill
Activates FromAfter First Paid Claim
Eligible Claim TypesHospitalization, AYUSH
Watch out
It applies only to claims admitted under In-patient Treatment, Day Care Treatment or In-patient AYUSH Hospitalisation, and only inside India.
Twelve technological advancements - robotic surgery, oral chemotherapy, stem cell therapy for bone marrow transplant, deep brain stimulation, stereotactic radiosurgery and the rest - are covered up to your full Sum Insured, with no per-procedure cap.
Coverage detailstap any row to understand it
Coverage ScopeListed Procedures (standard IRDAI list)
Expense limitCovered up to full Sum Insured
Sub-limit Modification AvailableNo
Watch out
The table is the standard IRDAI set, so it is not a narrow list, but a technique newer than the table is not covered. Under the Worldwide Cover option a further group is excluded, including cyber knife treatment, femto laser surgery and bioabsorbable stents.
Sold as an optional cover. On first diagnosis of any of 20 named critical illnesses - cancer, first heart attack, stroke, kidney failure, major transplant and more - Elevate pays a lump sum of up to ₹50,00,000 in cash, over and above your hospital cover. You can buy it only between the ages of 18 and 50, and it pays once in your lifetime.
Coverage detailstap any row to understand it
How it's coveredOptional add-on
Number of Critical Illnesses Covered20 illnesses
Payout TypeLump Sum on Diagnosis
Maximum Sum Insured Option (INR)₹50 Lakh
Survival Period Post-Diagnosis (Days)0 days
Watch out
A 90-day waiting period applies from the start of the cover, and the wording sets no survival period after diagnosis. No claim is paid if the critical illness is a consequence of a pre-existing disease.
When does my cover switch on?2 of 4 are priority
Anything a doctor diagnosed, advised on or treated in the 36 months before you bought, waits 36 months before it is paid for. You can pay to cut that wait to 24 or 12 months, but only at policy start. A separate optional cover, Jumpstart, brings six common conditions - including diabetes and high blood pressure - into cover from Day 31.
Coverage detailstap any row to understand it
Standard Waiting Period (Months)36 months
Coverage Condition After Waiting PeriodCovered if Declared at Policy Start
Portability / Migration Credit Reduces Waiting PeriodYes
Waiting period reductionReducible to 12 months, 24 months - opt-in Policy Start Only, locked in once chosen, available to Customer
Watch out
Both buy-downs have to be chosen when the policy starts; you cannot add them at a later renewal, and each must be kept for 3 continuous policy years. If you raise your Sum Insured later, the 36-month wait starts again on the increased amount. After 60 continuous months of cover, no claim can be contested except on grounds of established fraud.
Twenty-three everyday conditions and operations - cataract, hernia, piles, kidney and gallbladder stones, hysterectomy, joint replacement and a slipped disc among them - wait 24 months. You can pay to cut that to 12 months, but only at policy start. Accident claims are outside this wait.
Coverage detailstap any row to understand it
Waiting Period (Months)24 months
Portability Credit Reduces Waiting PeriodYes
Pre-existing Disease Wait Applies if LongerYes
Accident Claims Exempt from Any Waiting PeriodYes
Waiting period reductionReducible to 12 months - opt-in Policy Start Only, locked in once chosen, available to Customer
Watch out
If a listed condition is also a pre-existing disease, the longer 36-month wait applies instead of 24 months. Raising your Sum Insured restarts the 24-month wait on the increased amount. Weight-loss surgery sits outside the list and carries its own 24-month wait, which drops to 30 days if you buy Jumpstart.
Planning a baby2 of 3 are priority
Maternity is not in the base cover. You buy it one of two ways, and only one at a time: Optional Cover 5 pays 10% of your Sum Insured up to ₹1 Lakh, on a family floater policy only, or the Elevate HER Nurture add-on gives a separate maternity Sum Insured of ₹75,000 to ₹2,00,000. Both carry a 24-month waiting period.
Coverage detailstap any row to understand it
How it's coveredOptional add-on
Maternity expense limit10% of Sum Insured, up to ₹1 Lakh
Pre-natal Expenses IncludedYes
Post-natal Expenses IncludedYes
Waiting period24 months
Watch out
Optional Cover 5 pays at most ₹1 Lakh for a delivery, and you can buy it only on a family floater policy at a renewal. You cannot hold it together with the Elevate HER Women Care add-on, so taking one rules out the other.
Your newborn gets its own cover for the first 90 days, but only if you bought a maternity optional cover and a maternity claim was paid. The amount is twice your maternity limit, capped at ₹2,00,000, and it is paid on top of your Sum Insured, not out of it. A separate optional cover pays first-year vaccinations up to ₹10,000.
Coverage detailstap any row to understand it
How it's coveredOptional add-on
Newborn expense limitUp to ₹2 Lakh per year
Coverage Starts from Day of Life1 day
Reduces Main Sum InsuredNo
What the baby's cover depends onOnly when this plan pays the delivery claim
Watch out
The 90 days count from birth, not from admission, so a NICU stay that begins late in that window stops being paid on day 91. The cover is switched on by an accepted maternity claim, so it depends entirely on the delivery claim going through.
Everyday medical costs2 of 7 are priority
Out-patient care is excluded from Elevate unless you buy the BeFit Optional Cover. BeFit pays doctor consultations, prescribed tests and prescribed medicines, but only cashless through the insurer's app and network. What you get depends on the BeFit plan: the largest gives 12 consultations plus ₹7,500 for tests and ₹7,500 for medicines a year, the smallest one consultation and ₹500 each.
Coverage detailstap any row to understand it
How it's coveredOptional add-on
OPD limit₹7,500 per year
GP consultationsCovered - up to 12/year
Diagnostic Tests CoveredYes
Medicines / Pharmacy CoveredYes
Watch out
BeFit starts 30 days after you buy it, and nothing unused carries to the next year. Dental treatment, genetic studies, supplements, vitamins and vaccinations stay outside it. You can only add BeFit up to age 65, at first purchase.
Out-patient care is excluded unless you buy BeFit, which gives online counselling sessions with a psychologist - six a year on the smallest plan, unlimited on the top two.
Coverage detailstap any row to understand it
How it's coveredIncluded in the base plan
OPD and therapyIn-patient only, no OPD or therapy
In-patient expense limitCovered up to full Sum Insured
Mental health add-onAvailable - BeFit (e-Counseling) - includes OPD mental health
Mental conditions coveredAcute depression, Anxiety, OCD, PTSD
Watch out
BeFit keeps mental-health counselling inside its e-counselling session count, so you cannot spend the physical-consultation quota on a psychiatrist's visit. Those sessions are online, with a psychologist. Treatment for alcohol, drug or substance abuse is excluded outright.
Worth it if I never claim?2 of 4 are priority
Called the Loyalty Bonus. 20% of your Sum Insured is added on for the next year at every renewal, whether or not you claimed, up to a ceiling of 100%. You can spend it only after the Sum Insured itself is used up, and it does not apply on the unlimited Sum Insured option.
Coverage detailstap any row to understand it
How it's coveredIncluded in the base plan
What the insurer calls itLoyalty Bonus
Bonus growthGrows 20% of Sum Insured every year (even after claims), up to 100% of Sum Insured
Requires Renewal Without BreakYes
Eligible Claim TypesBase Coverage Only
Watch out
Two optional covers lift the yearly bonus to 100% of Sum Insured with no ceiling - Power Booster and Power Booster Plus - but you can hold only one of them at a time. None of the accrued bonus is available for Worldwide Cover, Bariatric Surgery Cover or Claim Protector claims.
Optional Cover 20 - Voluntary Deductible lowers your premium in return for you paying the first slice of each year's hospital bills yourself. It works on an aggregate basis across all base covers: the insurer starts paying only once your claims for the period add up past the deductible written in your Policy Schedule. The amount you pay does not reduce your Sum Insured.
Coverage detailstap any row to understand it
AvailabilityOffered as an optional feature
Deductible waiverNo waiver option
Deductible Resets EveryPolicy Year
High Deductible Levels Restrict Other BenefitsNo
Deductible Can Only Be Increased at RenewalNo
Watch out
You cannot take this and the Voluntary Co-Payment option together, and the Vital Essence add-on rules out both. Once chosen, the deductible is fixed for the policy term - you can change it only at renewal, and only if underwriting agrees. It applies per person on an individual policy and on a floater basis on a family floater, so a family's bills count together towards one figure.
0233 illnesses
33 named illnesses wait 24 months accidents from day 1 read by 9 body regions about 3 min
How long you wait, for what
Accidents
Day 1Covered from the first day, with no waiting at all.
Illness, in general
30 daysAfter the first month, ordinary illness is covered.
The listed conditions
24 monthsEach one is then covered, like any other illness.
What you already had
36 monthsConditions you declared when you bought the plan.
Nothing more to prove
60 monthsAfter this, only proven fraud can be held against a claim.
Already diagnosed with one of these? A different rule applies - conditions you already have follow the pre-existing waiting period.
Entire Body
33 ConditionsWaiting Period: 24 months
Kidney & Urinary System
Renal Calculi
Kidney Stones
Lower Abdomen & Pelvis
Hard stone-like deposits in the kidney, ureter or bladder that can block urine and cause severe pain.
The exact words
“Stones in the urinary and biliary systems.”
Section d.i.2 (Excl02) · page 84
Chronic Kidney Disease
Long-term kidney failure
Lower Abdomen & Pelvis
The kidneys slowly lose their power to clean the blood; the late stage needs dialysis or a transplant.
The exact words
“Dialysis required for chronic renal failure.”
Section d.i.2 (Excl02) · page 84
Reproductive Health
Abnormal Uterine Bleeding
Abnormal menstrual bleeding
Lower Abdomen & Pelvis · Female
Very heavy or unusual bleeding during periods.
The exact words
“Dysfunctional uterine bleeding.”
“Dilatation and curettage.”
Section d.i.2 (Excl02) · page 84
Endometriosis
Lower Abdomen & Pelvis · Female
A painful problem where womb tissue grows outside the womb.
The exact words
“Endometriosis.”
Section d.i.2 (Excl02) · page 84
Benign Prostatic Hyperplasia
Enlarged prostate
Lower Abdomen & Pelvis · Male
A common swelling of a male gland that causes trouble urinating.
The exact words
“Benign prostatic hypertrophy.”
Section d.i.2 (Excl02) · page 84
0333 listed
4 never paid 13 paid only if a condition is met 15 in every policy read from all 33 under a minute
Never paid
4 clausesNo waiting period reaches these - the plan does not cover them at all.
Anything printed under "Special Conditions" on your own Policy Schedule is excluded - an illness, an injury, a treatment or a service. The clause does not limit what can be written there, so the printed policy document is not the full list of what this policy will not pay for. Your own Policy Schedule adds to that list. Nothing in this clause sets an end date for an exclusion written there. So read the Special Conditions on your schedule as soon as the policy is issued, and ask the insurer to explain anything you do not recognise.
32. Any Illness or Injury or treatment or service that is specifically excluded in the Policy Schedule under "Special Conditions".
POL p.89 d.ii.32
Insurance may not pay for general caretaking. Staying at a facility just to rest is not covered. Hiring helpers for daily tasks like walking or dressing may also be paid from your own pocket.
Rest Cure, Rehabilitation and Respite care- Code- Excl05. Expenses related to any admission for enforced bed rest and not for receiving treatment are excluded. This also includes: Custodial care, either at home or in a nursing facility, for personal care such as help with activities of daily living, such as bathing, dressing, and moving around, either by Qualified Nurses or assistants or non-skilled persons.b. Any services for people who are terminally ill to address physical, social, emotional and spiritual needs.
POL p.85 d.i.6 (Code- Excl05)
Acupressure, acupuncture and magnetic therapy are excluded outright. The clause also says "and other therapies", so it is not limited to the three it names. Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy are not excluded by this clause. So you pay for acupressure, acupuncture, magnetic and other non-allopathic therapies from your own pocket.
27. Acupressure, acupuncture, magnetic, and other therapies.
POL p.88 d.ii.27; Basic Cover 6 In-patient AYUSH Hospitalization POL p.13
Screening, counselling and treatment for external birth defects are excluded, and there is no exception for a newborn baby. "External" means a defect on the outside of the body, not one inside it. This clause does not name internal birth defects, so they are paid as an ordinary illness.
30. Screening, counselling, or treatment relating to external birth defects and external congenital Illnesses or defects or anomalies.
POL p.89 d.ii.30; Women Cancer Benefit POL p.79
Paid, but only if…
13 clausesWritten as exclusions, but the policy states a way in. The condition is the whole point.
When it IS paid
"Where Emergency Care is required following an Illness or Injury, expenses up to the stage of stabilization are payable but not the complete claim."
Insurance companies have a list of banned hospitals and doctors. If you go to them, your claim may be rejected. The exceptions are a life-threatening emergency or an accident - and even then the policy pays only up to the point you are stabilised.
Excluded Providers: Code- Excl11. Treatment in any Hospital or by any Medical Practitioner or any other Service Provider / Network Provider specifically excluded by Us and disclosed on Our website / notified to You. a. However, where Emergency Care is required following an Illness or Injury, expenses up to the stage of stabilization are payable but not the complete claim. b. (The list of excluded Service Providers / Network Provider / delisted Hospitals is available on our website www.icicilombard.com).
POL p.86 d.i.12 (Code- Excl11)
When it IS paid
Paid if you opt for Optional Cover 10 Claim Protector: "If a claim is accepted under the Basic Cover- In-Patient Treatment or Basic Cover - Daycare Treatment, the non-payable items included under List I- Items for which coverage is not available in the Policy of Annexure II will become payable under this cover."
The insurer does not pay the 68 items on List I of Annexure II, so you pay them from your own pocket. The list includes belts, braces and baby food. On a long stay, all these small charges together become a large amount. If you opt for the Claim Protector add-on, List I becomes payable whenever an in-patient or day-care claim is accepted. Personal comfort items the policy names, such as television, telephone, cosmetics and toiletries, are struck off the bill as well.
Annexure II. List I- Items for which coverage is not available in the Policy. 1 BABY FOOD 2 BABY UTILITIES CHARGES 3 BEAUTY SERVICES 4 BELTS/ BRACES 5 BUDS …
If a claim is accepted under the Basic Cover- In-Patient Treatment or Basic Cover - Daycare Treatment, the non-payable items included under List I- Items for which coverage is not available in the Policy of Annexure II will become payable under this cover.
26. Personal comfort, cosmetics, convenience, and hygiene related items and services.
POL pp.106–108 Annexure II, List I- Items for which coverage is not available in the Policy (68 items); Optional Cover 10 Claim Protector POL p.40; POL p.88 d.ii.26 · cl. Annexure II List I, d.ii.26
When it IS paid
Diagnostic expenses are paid when they are related or incidental to the diagnosis and treatment you were actually admitted for.
Health insurance pays for actual medical treatments. If you stay in a hospital purely for diagnostic tests or scans, the bill may not be covered. There must be an active treatment going on.
Investigation & Evaluation- Code- Excl04. Any admission for diagnostics and evaluation purposes only, and any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment.
POL p.85 d.i.5 (Code- Excl04)
When it IS paid
Paid when a Medical Practitioner prescribes them "as part of Hospitalization or Day Care Treatment".
General vitamins and supplements are not covered. You may have to pay for them yourself. Insurance may only pay if a doctor strictly prescribes them during a hospital stay.
Dietary Supplements: Code- Excl14. Dietary supplements and substances that can be purchased without prescription, including but not limited to vitamins, minerals, and organic substances, unless prescribed by a Medical Practitioner as part of Hospitalization or Day Care Treatment.
POL pp.86–87 d.i.15 (Code- Excl14)
When it IS paid
Paid "for reconstruction following an Accident, Burn, or Cancer, or as part of Medically Necessary Treatment to remove a direct and immediate health risk to You", where the attending Medical Practitioner certifies the medical necessity.
Surgeries done just to look better are excluded. However, plastic surgery needed after a bad accident may be covered. Surgeries for burns or cancer reconstruction are also covered.
Cosmetic or Plastic Surgery: Code- Excl08. Cosmetic or plastic surgery or any treatment to change appearance, unless for reconstruction following an Accident, Burn, or Cancer, or as part of Medically Necessary Treatment to remove a direct and immediate health risk to You. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
POL p.86 d.i.9 (Code- Excl08)
When it IS paid
Paid "if required by an Insured Person while Hospitalized due to an Accident".
The dental exclusion in this plan is wide: treatment, procedures and preventive, diagnostic, restorative and cosmetic services for the natural teeth and gums are all excluded. Only one exception is paid - dental work you need while you are admitted to hospital because of an accident. If you need dental work because of a disease rather than an accident, or for everyday care, you pay for it from your own pocket.
24. Treatment, procedures and preventive, diagnostic, restorative, cosmetic services related to disease, disorder and conditions related to natural teeth and gingiva except if required by an Insured Person while Hospitalized due to an Accident.
POL p.88 d.ii.24; BeFit consultation exclusion POL p.34
When it IS paid
Paid if you opt for Optional Cover - BeFit, which funds out-patient consultations, routine diagnostics and minor procedures, pharmacy, physiotherapy, e-counselling and diet consultations up to its own per-head limits.
Out-patient treatment is excluded from the base plan. Doctor consultations, medicines, tests and physiotherapy taken without being admitted are paid only if you opt for the BeFit add-on, and then only up to the counts and rupee limits of the BeFit plan you choose. If you do not opt for BeFit, you pay every out-patient bill from your own pocket.
22. Out-Patient treatment, unless Optional Cover - BeFit has been opted.
POL p.88 d.ii.22; Optional Cover 6 BeFit POL pp.34–38
When it IS paid
Paid where the item is "necessitated by an Illness or Injury or required intra-operatively". Nine named items - CPAP machine, ventilator, wheelchair, prosthetic device, suction machine, commode chair, infusion pump, continuous passive motion device after knee replacement, and oxygen concentrator - are also paid if you opt for Optional Cover 22 Durable Medical Equipment Cover.
This plan does not pay for prosthesis, corrective devices or take-home medical equipment of any kind, and the clause names wheelchairs, crutches, machines used to treat sleep apnoea and cochlear implants. The exclusion does not apply if the item is needed because of an illness or injury, or if it is required during the operation itself. If you opt for the Durable Medical Equipment add-on, nine named items are paid: CPAP machine, ventilator, wheelchair, prosthetic device, suction machine, commode chair, infusion pump, continuous passive motion device after a knee replacement, and oxygen concentrator.
23. Any expenses incurred on prosthesis, corrective devices, external durable medical equipment of any kind, like wheelchairs, crutches, instruments used in treatment of sleep apnea syndrome or cost of cochlear implant(s), unless necessitated by an Illness or Injury or required intra-operatively.
POL p.88 d.ii.23; Optional Cover 22 Durable Medical Equipment Cover POL pp.54–55
When it IS paid
Paid where the device is "necessitated by an Illness or Injury or required intra-operatively" - the route that pays for a device fitted during an operation.
This plan treats spectacles, contact lenses, hearing aids and cochlear implants as corrective devices, so the same clause excludes them. They are paid only if the device is needed because of an illness or injury, or if it is required during the operation itself. That second exception applies to a device fitted during an operation, and not to an aid you take home. So you pay for spectacles and hearing aids from your own pocket.
23. Any expenses incurred on prosthesis, corrective devices, external durable medical equipment of any kind, like wheelchairs, crutches, instruments used in treatment of sleep apnea syndrome or cost of cochlear implant(s), unless necessitated by an Illness or Injury or required intra-operatively.
POL p.88 d.ii.23; Optional Cover 22 Durable Medical Equipment Cover POL pp.54–55
When it IS paid
Paid when the refractive error is 7.5 dioptres or more - the exclusion reaches only "correction of eye sight due to refractive error less than 7. 5 dioptres".
Surgeries to remove your glasses are usually not covered. They are seen as a cosmetic choice. The policy pays only when your eyesight is very weak - 7.5 dioptres or worse.
Refractive Error: Code- Excl15. Treatment for correction of eye sight due to refractive error less than 7. 5 dioptres.
POL p.87 d.i.16 (Code- Excl15)
When it IS paid
Paid when your doctor advises the surgery, it is supported by clinical protocols, you are 18 or older, and your Body Mass Index is 40 or more - or 35 or more together with obesity-related cardiomyopathy, coronary heart disease, severe sleep apnea or uncontrolled Type 2 diabetes after less invasive weight-loss methods have failed. Bariatric Surgery Cover then pays up to the Sum Insured, after a 24-month wait that reduces to 30 days if you opt for Jumpstart.
The policy pays for weight-loss surgery only when your doctor advises it, you are 18 or older, and your BMI is 40 or more - or 35 or more together with a condition like heart disease, severe sleep apnoea or uncontrolled diabetes. Surgery to change how you look is not covered.
Obesity/ Weight Control: Code- Excl06. Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions: 1. Surgery to be conducted is upon the advice of the Doctor 2. The surgery/Procedure conducted should be supported by clinical protocols 3. The member has to be 18 years of age or older and 4. Body Mass Index (BMI); a. greater than or equal to 40 or b. greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less invasive methods of weight loss: i. Obesity-related cardiomyopathy ii. Coronary heart disease iii. Severe Sleep Apnea iv. Uncontrolled Type2 Diabetes
POL pp.85–86 d.i.7 (Code- Excl06); Bariatric Surgery Cover POL p.17
When it IS paid
The same ART procedures - artificial insemination, IVF, ZIFT, GIFT and ICSI - are paid if you opt for the "Elevate HER Nurture-Maternity, Wellness & ART add-on", to that cover's own limits and waiting periods. Two inbuilt routes pay without that add-on: the oocyte donor's hospitalisation for complications of oocyte retrieval, and the surrogate mother's hospitalisation for pregnancy complications.
Medical costs for family planning are not covered. This means the policy may not pay for treatments to prevent pregnancy. It also may not pay for treatments to get pregnant.
Sterility and Infertility: Code- Excl 17. Expenses related to sterility and infertility. This includes: a. Any type of contraception or sterilization. b. Assisted reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI (except where admissible under Basic Cover – In-Patient Hospitalization for Oocyte Donor). c. Gestational Surrogacy (except where admissible under Basic Cover – In-Patient Hospitalization of the Surrogate Mother). d. Reversal of sterilization.
The above exclusion part b. Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI shall not apply to claims which are otherwise admissible under Basic Cover 14 "In-patient Hospitalisation for Oocyte Donor" which pertains to Medical Expenses incurred in respect of Hospitalization of the Oocyte donor for complications arising due to oocyte retrieval process"
The exclusion under Clause (b) above shall not apply to Medical Expenses towards Assisted Reproductive Technology (ART) procedures, including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, where the Insured Person has opted for the Optional Cover "Elevate HER Nurture-Maternity, Wellness & ART add-on", and such expenses are admissible strictly in accordance with the terms, conditions, waiting periods, sub-limits and other provisions specified under the said Optional Cover.
POL p.87 d.i.18 (Code- Excl 17); Basic Cover 13 Surrogate Mother POL pp.17–18; Basic Cover 14 Oocyte Donor POL p.18; Elevate HER Nurture POL pp.71–73
When it IS paid
"This exclusion will not be applicable in case Optional Cover- Maternity Benefit or Elevate HER Nurture plan has been opted." Maternity Benefit pays 10% of the Sum Insured capped at ₹1,00,000, after a 24-month wait from the date you opt for it.
Standard health policies may not cover the costs of pregnancy or childbirth. Normal deliveries and C-sections are excluded. The usual exception is an ectopic pregnancy; where a policy pays maternity as a benefit, its own wording says so.
Maternity: Code Excl18. a. Treatment traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic pregnancy. b. Expenses towards miscarriage (unless due to an Accident) and lawful medical termination of pregnancy during the policy period. c. This exclusion will not be applicable in case Optional Cover- Maternity Benefit or Elevate HER Nurture plan has been opted.
POL pp.87–88 d.i.19 (Code Excl18); Optional Cover 5 Maternity Benefit POL p.32; Elevate HER Nurture POL pp.71–73
Not yet - a wait applies
1 clauseCovered eventually, on a clock that isn't part of the standard waiting periods.
This plan applies a 90-day waiting period to hypertension, diabetes and cardiac conditions, counted from the first policy start date. If you are admitted for a heart problem in month two, the insurer does not pay, and you pay the hospital bill from your own pocket. If you already had one of these three conditions and you declared it when you applied, this 90-day wait does not apply to you. If you increase your Sum Insured later, the 90-day wait starts again for the increased amount. The 90-day wait stops applying once you have been covered continuously for more than 12 months.
90-day Waiting Period. Treatment of the below mentioned Illnesses within 90 days from the first Policy start date, unless they are Pre-existing Diseases and disclosed at the time of Policy issuance: i. Hypertension ii. Diabetes iii. Cardiac Conditions a. This exclusion shall not apply if You have continuous coverage for more than 12 months. b. The 90 day waiting period applies to the enhanced Sum Insured in the event of subsequent enhancements to the Sum Insured.
POL p.85 d.i.3 (90-day Waiting Period, un-coded)
047 discounts
3 just for qualifying 4 cost you a co-pay, a deductible or a smaller network about 5 min
Just for qualifying3
When it appliesPurchase & renewal
Stacks withNo bar is printed against any other discount. Where the wellness discount also applies, it is worked out first and the tenure discount after.
Printed atProspectus p.61 · Discounts/Loading Factors 1
Watch out
Only the final year's premium is discounted - a 5-year policy gets 15% off year 5, not off all five years
When it appliesPurchase & renewal
Stacks withNo bar is printed against other discounts. Only the Basic Covers are discounted - add-on premium is not.
Printed atPolicy wording pp.57–58 · Optional Cover 30; Prospectus p.30
Watch out
Must be proved again at every renewal - the discount stops from the renewal after you stop being an NRI
In exchange for something4
WorthNot published
When it appliesPurchase & renewal
Stacks withCannot be combined with Voluntary Deductible or with Vital Essence. Stacks with the tenure, zone and wellness discounts.
Printed atPolicy wording p.53 · Optional Cover 19; Prospectus p.27
In return
You pay your agreed share of every approved claim yourself, on all Basic Covers except the Wellness Program, and on Infinite Care and Worldwide Cover as well.
Watch out
Cannot be changed mid-term - a change waits for renewal and needs underwriting approval
WorthNot published
When it appliesPurchase & renewal
Stacks withCannot be combined with Voluntary Co-Payment or with Vital Essence. Stacks with the tenure, zone and wellness discounts.
Printed atPolicy wording p.53 · Optional Cover 20; Prospectus p.27
In return
Each policy year you pay hospitalisation costs up to your chosen deductible yourself before the policy pays - counted per person on an individual policy, and across the whole family on a floater.
Watch out
Cannot be changed mid-term - raising or lowering it waits for renewal and needs underwriting approval
When it appliesPurchase & renewal
Stacks withNo bar is printed against any other discount, including Voluntary Co-Payment.
Printed atPolicy wording p.57 · Optional Cover 29; Prospectus p.29
In return
A 20% co-payment applies on each and every claim where treatment is taken outside the listed network, with no exception written in for emergencies. The insurer may also add to, change or reduce that network at its own discretion after you buy.
WorthNot published
When it appliesPurchase only
Stacks withCannot be combined with Voluntary Co-Payment or with Voluntary Deductible. Stacks with the tenure, zone and wellness discounts.
Printed atPolicy wording pp.64–68 · Optional Cover 33; Prospectus pp.37–39
In return
A co-payment agreed in advance comes off every claim, applied before any sub-limit. Lifetime caps per disease then apply - ₹30,000 an eye for cataract, ₹1,00,000 per knee or hip replacement, ₹2,00,000 a year for stroke and heart disease, cancer, kidney disease and long-bone surgery, ₹80,000 a year for hernia, hysterectomy, prostate and kidney stones, and ₹80,000 a year for surgery on diabetes complications. The Reset Benefit also drops from unlimited to once a policy year.
Watch out
Chosen at first purchase only - dropping it at renewal withdraws the discount and the premium is worked out again on a fresh risk assessment
Not offered: a family or multi-member discount - a floater is priced on the eldest member's age instead · a loyalty or existing-customer discount · an employee or group affiliation discount · an online or direct-purchase discount · a fixed no-claim premium discount - claim-free years add Sum Insured through the Loyalty Bonus instead.
05
under a minute
ICICI Lombard
Filed plan · UIN ICIHLIP27057V062627
General insurerSince 2000
0610 comparisons
10 comparisons, every clause that differs under a minute
Sources
Everything on this page is read from the insurer’s own filings. It is an educational summary - not advice, not a recommendation to buy, and we sell nothing.
Plan facts last updated 9 Sept 2026.
IRDAI UIN: ICIHLIP27057V062627
2 documents we read this from under a minute