Overview
ICICI Lombard's Health Shield 360 plan is a comprehensive group health insurance designed for bank account holders and other subsidiary customers. It offers extensive coverage for inpatient and outpatient hospitalization, pre- and post-hospitalization expenses, daycare procedures, and maternity benefits. The plan includes a short waiting period of just 30 days for pre-existing conditions, making it attractive for those seeking immediate coverage. Additionally, it provides worldwide coverage and features like unlimited reset benefits and cashless hospitalization at over 10,200 network centers.
Experts Review
Written by Nikhil Nair
Senior Writer
The Health Shield 360 plan stands out for its comprehensive coverage and affordability. The short waiting period of 30 days for pre-existing conditions is a significant advantage, allowing policyholders to access benefits quickly. The inclusion of outpatient treatment, maternity, adds value beyond standard hospitalization expenses. The unlimited reset benefit ensures that the sum insured is reinstated for multiple claims within a policy year, providing robust financial protection.
However, as a group plan, Health Shield 360 lacks the stability and customization options available in individual policies. The arrangement can be terminated by the bank at any time, which may leave policyholders without coverage. Additionally, the plan’s worldwide coverage comes with travel restrictions, such as a maximum stay of 45 days abroad per trip.
In comparison to the retail version of Health Shield 360, the group plan offers more affordable premiums but lacks the flexibility and control over policy terms that individual plans provide. For those seeking comprehensive coverage with minimal waiting periods and who are comfortable with the risks associated with group plans, Health Shield 360 is a viable option. However, individuals prioritizing policy stability and customization may prefer the retail variant of the plan.
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. Need to opt add-on for maternity cover.
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
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
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 you wait for 30 days.
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
NCB Super
Recommended
Additional bonus of 50% up to a maximum of 100%, with a clawback of 50% if claimed in the previous year.
OPD
Get coverage for outpatient consultations i.e. doctor visits. However, the coverage is limited to specified amounts based on the cover amount taken.
Maternity Benefits
Get coverage for maternity expenses i.e. childbirth and newborn expenses. However, the coverage is limited to specified amounts based on the cover amount taken.
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 1 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
1 years Specific illness waiting period
Ditto's Take
◦ ◦
What's missing in the policy
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
Hema Mishra
Short waiting period of just 30 days for pre-existing conditions is amazing for immediate coverage needs!
H
Himanshu Iyer
Worldwide coverage is a great feature, especially for a group plan.
I
Ila Menon
Unlimited reset benefits ensure continuous coverage even with multiple claims.
J
Jeevan Chandra
Customer service experience might depend on the bank's coordination with ICICI.
J
Jatin Das
Being a group policy, it might have limitations or changes dictated by the bank, not the individual.
J
Jagdish Jain
Covers in-patient and out-patient hospitalization, which is comprehensive.
K
Kartik
Seems like a well-rounded plan for various needs.
L
Leena
Good to have a policy that covers diverse medical expenses.
M
Manoj
The coverage feels comprehensive as advertised.
T
Tina
The policy wording could be simpler to understand.
R
Rina
Need more clarity on the sub-limits, if any.
P
Priya
Feels like a complete health protection package.
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Frequently Asked Questions
Does Health Shield 360 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 1-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 30-day waiting period for any pre-existing disease you may have while buying the policy.
- 90-Day Waiting Period: There's a 90-day waiting period for conditions arising out of Hypertension, Diabetes, cardiac unless declared as a PED.
Does Health Shield 360 have room rent restrictions?
Does Health Shield 360 offer a restoration benefit?
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