Overview
The ICICI Lombard Health Booster Super Top-up plan is designed to provide an additional layer of health coverage beyond your existing base policy, with sum insured options up to ₹50 lakhs. It operates on a deductible model, covering cumulative medical expenses exceeding the deductible within a policy year. The plan offers flexibility in sum insured and deductibles, no room rent restrictions, and includes benefits like restoration of sum insured [ once in a policy year for unrelated illness], wellness programs, and coverage for AYUSH and domiciliary treatments.
Experts Review
Written by Nikhil Nair
Senior Writer
The ICICI Lombard Health Booster Super Top-up plan stands out as one of the most flexible and comprehensive super top-up options in the Indian market. Its key USP is the absence of room rent restrictions, allowing policyholders to choose any room category without impacting claim settlement—a feature not common in many super top-up plans.
The plan covers a wide range of medical expenses, including domiciliary hospitalization and donor expenses, and offers restoration of the sum insured, which replenishes coverage once a year for unrelated illness. With no co-pay or disease-wise sub-limits, 60-90 days pre- and post-hospitalization cover, PED coverage after 2 years, and a 10% loyalty bonus up to 50%, the plan stands out as a solid option to consider.
However, the plan’s premiums tend to be 10-15% higher than comparable super top-up plans, reflecting its broader coverage and flexibility. Compared to other super top-ups, such as HDFC ERGO, Medisure offers superior sum insured limits (up to ₹50 lakhs) and more add-on options, but at a higher premium.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Maternity benefits not offered, which is a notable gap.
Doctor consultations are not covered, which could be a drawback for some. 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
Co-payment
If you bought this policy after you turned 61, you have to pay 20% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
Room Rent
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
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 just 2 years. It’s probably the best deal you can get to be honest.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 90 days after discharge. This includes the cost of medication by the way.
Add-ons
BeFit cover
Get coverage for outpatient and e-consultations i.e. doctor visits upto defined limits as per amount chosen.
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 3 days, with a maximum payout of ₹1000 for up to 30 days.
Critical Illness
Paid out as a lump sum of 100% of sum insured for listed Critical illnesses for insured aged 18 to 60 years.
Personal Accident cover
Paid out as a lump sum of 100% of sum insured for Accidental Death, Total Permanent Disability, Permanent Partial Disability.
Convalescence Benefit
Payouts a fixed amount in case the hospitalization exceeds more than 10 continuous days. This benefit is available once per insured member per policy year.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
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.
Services for terminally ill individuals addressing non-medical needs are 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.
ENT-related conditions:
Sinusitis
Deviated Nasal Septum
Treatment for tonsils, adenoids, sinuses
Mastoidectomy
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
2 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
After a close look at the waiting periods, we can say that the waiting periods on this policy are excellent. Especially the PED waiting period which is better than usual.
What's missing in the policy
Maternity benefits not offered.
Doctor consultations are not covered. Need to opt add-on for doctor consultations.
Customer Reviews
H
Hema
Boosts my existing coverage significantly.
I
Ishan
Great for increasing sum insured at a lower cost.
J
Jaya
Provides extra coverage for major illnesses.
Q
Qasim
Is the claim process smooth for the top-up?
O
Om
The deductible is a bit high.
M
Manoj
Essential for higher medical expenses.
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Frequently Asked Questions
Does Health Booster Super Top-up 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 2-year waiting period for any pre-existing disease you may have while buying the policy.
Does Health Booster Super Top-up have room rent restrictions?
Does Health Booster Super Top-up offer a restoration benefit?
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