Overview
The ICICI Lombard Elevate plan is a cutting-edge health insurance policy designed to provide extensive coverage with unparalleled customization options. It offers sum insured options ranging from ₹5 lakhs to unlimited coverage, making it suitable for individuals and families with diverse healthcare needs. Key benefits include the Infinite Care, Jumpstart, and the Claim Protector add-ons. The plan also includes a surrogate & oocyte donor expenses up to 5L, wellness benefits which can provide up to 30% discount on renewal premium, bariatric surgery cover up to SI.
Experts Review
Written by Nikhil Nair
Senior Writer
The ICICI Lombard Elevate plan is a highly versatile health insurance option that caters to a wide range of healthcare needs. Its standout feature is the Reset benefit, which allows policyholders to restore their sum insured repeatedly within the same policy year. In addition, the Power Booster add-on further enhances coverage by offering a 100% cumulative bonus for an infinite period, rewarding long-term policyholders.
The plan’s flexibility is unmatched due to its extensive add-ons, which include durable medical equipment cover (OPD cover), maternity benefits (10% of cover amount up to ₹1 lakh), PED waiting period reduction (to as low as 30 days), and critical illness coverage. Unique features like surrogate mother and oocyte donor expense coverage make it appealing for families exploring advanced reproductive options. Additionally, wellness discounts of up to 30% and digital tools like BeFit promote preventive care and incentivize healthy living.
On the downside, ICICI Lombard’s claim settlement ratio (85%, average of 2021-24) is below industry standards and may raise concerns about operational efficiency during claims processing. While the plan’s premium pricing is competitive for its features, prospective buyers should carefully assess their healthcare needs and evaluate the insurer’s track record before opting for this policy.
Pros
Feature set is satisfactory.
Great pick if you're looking for something affordable.
Insurer has a solid track record with great claim and service metrics.
Offers Surrogate & Oocyte Cover, which makes this policy stand out.
Cons
Your insurer doesn’t provide free health check-ups, which is a notable gap.
Maternity benefits not offered, which could be a drawback for some. Need to opt add-on for maternity cover.
Doctor consultations are not covered, which is a key feature. Need to opt add-on for doctor consultations.
ICICI Lombard
Key Insights
Founded
2001
ICICI Lombard was established 24 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
85% claims settled in 30 Days
ICICI Lombard settles only 85% of claims it receives, which is relatively low and may raise concerns about reliability during claim payouts.
Network Hospitals
10,200+
ICICI Lombard maintains a moderate network of 10,200 hospitals, offering reasonable coverage across key locations.
Complaints
11 complaints per 10,000 claims registered
ICICI Lombard experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
Features
All
Great
Good
Surrogate & Oocyte Cover
STANDOUT
This policy provides coverage for surrogate mother and Oocyte donor expenses up to ₹5 lakhs.
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Customisable
Choose a co-payment between 10% and 50% to reduce premiums.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Customisable
Change Single Private Room to Any Room or Twin Sharing Room.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Customisable
For any illness: Pre existing disease waiting period is modified/reduced from 3 years to 1 or 2 years.
Customisable
For Asthma, Diabetes, Hypertension, Cholesterol, Obesity or Coronary Artery Disease (PTCA done prior to 1 year): Pre existing disease waiting period is reduced from 3 years to 30 days.
Add-ons
Reduction in PED
Recommended
For any illness: Pre existing disease waiting period is modified/reduced from 3 years to 1 or 2 years.
Jumpstart
Recommended
For Asthma, Diabetes, Hypertension, Cholesterol, Obesity or Coronary Artery Disease (PTCA done prior to 1 year): Pre existing disease waiting period is reduced from 3 years to 30 days.
Claim Protector
Recommended
Covers list of 68 non-medical items as per list I
Annual Health Checkup
Recommended
Annual health check-up for specified tests, with a maximum limit up to the sum insured on a cashless or reimbursement basis.
Power Booster
Recommended
Additional bonus of 100% up to a maximum of null%, irrespective of any claim in the previous year.
Inflation Protector
Recommended
Cover increases in line with inflation.
Maternity Benefits
Maternity expenses covered up to 10% of sum insured with limit of ₹1,00,000 after a waiting period of 1 to 2 years.
Critical Illness
Paid out as a lump sum of 100% of sum insured for 20 listed Critical illnesses up to a limit of Rs. 50 lakhs for insured aged 18 to 50 years at the time of policy purchase.
Personal Accident Cover
Paid out as a lump sum of 100% of sum insured for Accidental Death, Total Permanent Disability, Permanent Partial Disability up to a limit of ₹5000000.
Room Rent Modifier
Change Single Private Room to Any Room or Twin Sharing Room.
Compassionate Visit
Lump sum payout of a certain amount to cover the cost of economy-class air ticket in case an Immediate Family member is visiting the insured person for hospitalization extending more than 5 days.
Co-payment
Choose a co-payment between 10% and 50% to reduce premiums.
BeFit
Get coverage for outpatient and e-consultations i.e. doctor visits upto defined limits as per amount chosen.
Maternity Waiting Period Reduction
Reduces the maternity waiting period from 2 years to 1 year.
Infinite Care
Covers the medical expenses incurred for the hospitalization of the insured person for any one claim during the lifetime of the policy, without any limits on the annual sum insured.
Reduction in Specific Illness Waiting Period
Reduces the Specific Illness Waiting Period from 2 years to 1 year.
Convalescence Benefit
Lump sum payout of a fixed amount in case the hospitalisation exceeds more than 10 continuous days. This benefit is available once per insured member per policy year.
Dependent Accommodation
Lump sum payout of a specified amount for the accommodation of the dependent in the hospital if the hospitalisation is of at least 3 days.
Durable Equipment Cover
Cover the cost of durable items like Ventilator, Wheelchair, Prosthetic device, Suction Machine, etc up to 5L or base sum insured; whichever is lower.
Nursing at home
Lump sum payout of a certain amount each day for medical services of a nurse at residence for a maximum of 15 days post hospitalisation.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
STDs except HIV
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Gastric and Duodenal Ulcers (all types)
Benign Prostatic Hypertrophy
Sinus-related conditions:
All types of sinuses
Paranasal sinuses
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting periodCustomisable
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. This policy also further allows to reduce the PED waiting period to 1 or 2 years for all diseases and to 30 days for certain diseases.
What's missing in the policy
Your insurer doesn’t provide free health check-ups.
Maternity benefits not offered. Need to opt add-on for maternity cover.
Doctor consultations are not covered. Need to opt add-on for doctor consultations.
Customer Reviews
H
Hemant N.
Reset benefit allowing repeated restoration of SI in a year is fantastic! Truly unlimited feel.
I
Ishan O.
Power Booster add-on with 100% cumulative bonus for an infinite period is an amazing long-term benefit.
J
Juhi P.
Surrogate mother and oocyte donor expense coverage is very progressive and unique.
Q
Qasim W.
Understanding all the add-ons and their benefits/costs takes time and effort.
O
Omar U.
ICICI's claim settlement ratio (85%) is a bit concerning. Hope it improves.
M
Mohan S.
PED waiting period can be reduced to as low as 30 days with an add-on. Superb!
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Frequently Asked Questions
Does Elevate have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
- 90-Day Waiting Period: Hospitalizations won’t be covered for Diabetes, Hypertension and Cardiac conditions if these are not diagnosed as PEDs at the time of purchase.
Does Elevate have room rent restrictions?
Does Elevate offer a restoration benefit?
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