Overview
ICICI Lombard's Health Elite Plus is a comprehensive health insurance plan with coverage of up to ₹3 crore. It features unlimited reset of sum insured, worldwide coverage (for higher sum insured), air ambulance cover, and AYUSH treatment. The policy includes flexible add-ons like BeFit and Sum Insured Protector, making it ideal for individuals and families seeking extensive healthcare protection with customizable options.
Experts Review
Written by Nikhil Nair
Senior Writer
ICICI Lombard's Health Elite Plus is a plan that packs quite a punch. The unlimited reset benefit for different illnesses (and once for the same illness) is a standout feature. At the same time, the inclusion of air ambulance cover shows they're thinking beyond just the basics.
With features like health coaching and discounts on health-related products, it's clear that the insurer is invested in preventive care. For the globetrotters among us, the policy’s worldwide coverage for higher sum insured plans is a nice touch.
Now, let's talk about the room rent situation. There's no capping for sum insured above ₹20 lakhs; but for lower sum insured, you're looking at a single private AC room limit, which is not bad, but something to keep in mind. Another caveat is that the policy has a 90-day waiting period for diabetes, hypertension, and cardiac conditions, even if they're not pre-existing. This is common across most ICICI Lombard policies.
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.
Cons
Maternity benefits not offered, which is a notable gap.
Doctor consultations are not covered, which could be a drawback for some.
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
Bad
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.
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.
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for cataracts. Meaning the insurance company has a cap of 10% of the base cover, maximum up to 1 lakh per eye if you are treated for the same.
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 180 days after discharge. This includes the cost of medication by the way.
Add-ons
Sum Insured Protector
Recommended
Cover increases in line with inflation.
Claim Protector
Recommended
Covers list of 68 non-medical items as per list I
BeFit cover
Get coverage for outpatient and e-consultations i.e. doctor visits upto defined limits as per amount chosen.
International Coverage
Get coverage for planned treatment for 45 days per trip and a total of 90 days per year till the age of 65 years with mandatory co-payment of 10%.
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 hospitalisation extending more than 5 days.
Nursing at home
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.
Cataract
Benign Prostatic Hypertrophy
Myomectomy and Hysterectomy (unless because of malignancy)
All types of Hernia and Hydrocele
Anal conditions:
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.
Customer Reviews
A
Ashok Sharma
Unlimited reset of sum insured for different illnesses is a game-changer! Even once for same illness is good.
B
Bharati Verma
Worldwide coverage for higher sum insured plans is perfect for globetrotters like me.
B
Bhavesh Gupta
Air ambulance cover included is a sign of comprehensive protection.
G
Gita Joshi
Sublimits on cataract and home care treatments need to be checked carefully.
D
Divya Khan
90-day waiting period for diabetes, hypertension, cardiac conditions even if its not pre-existing is a bit unusual.
D
Deepa Patel
No room rent capping for sum insured above ₹20 lakhs is a relief.
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Frequently Asked Questions
Does Health Elite Plus 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.
- 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 Health Elite Plus have room rent restrictions?
Does Health Elite Plus offer a restoration benefit?
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