Overview
ICICI Lombard’s Health Shield 360 offers coverage of up to ₹3 crore. The policy also offers wellness programs with rewards for maintaining a healthy lifestyle, no room rent limits, and coverage for modern treatments. With flexible add-ons and lifelong renewability, it’s a good plan for those seeking extensive and customizable healthcare protection.
Experts Review
Written by Nikhil Nair
Senior Writer
The Health Shield 360 policy by ICICI Lombard is a well-rounded health insurance plan that caters to diverse medical needs. Its 100% reset benefit is a notable highlight that ensures you’re never left without coverage in case of multiple claims in a year. Other features include air ambulance cover, AYUSH treatments, and modern procedures like robotic surgeries and oral chemotherapy.
The wellness program deserves special mention. It not only rewards healthy behavior with redeemable wellness points but offers personalized health coaching through their intuitive app. At the same time, for those who travel frequently or want global medical access, the optional worldwide coverage add-on is a solid choice.
On the flip side, premiums might feel steep if you opt for higher coverage or add-ons like reduced waiting periods. Additionally, the insurer’s less than 90% average claim settlement ratio is worth taking another look at before making a final purchase decision.
Pros
Offers a wide range of features.
Great pick if you're looking for something affordable.
Insurer has a solid track record with great claim and service metrics.
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
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 1-2 years.
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 - 30 days before you are hospitalized and 60 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
NCB Super
Recommended
Additional bonus of 50% up to a maximum of 100%, with a clawback of 50% if claimed in the previous year.
Annual Health Checkup
Annual health check-up for specified tests, with a maximum limit up to the sum insured on a cashless or reimbursement basis.
BeFit
Get coverage for outpatient and e-consultations i.e. doctor visits upto defined limits as per amount chosen.
Maternity
Get coverage for maternity expenses i.e. childbirth . However, the coverage is limited based on the plan taken with Maternity Waiting Period ranging between 2-3 years.
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 3 days, with a maximum payout based on cover amount for up to 10 days.
International Coverage
Get coverage for planned treatment for 45 days per trip and total of 90 days per year till the age of 65 years with a mandatory co-payment of 10%.
Compassionate Visit
Lump sum payout of Rs. 20,000 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.
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
Pays a specified amount for the accommodation of the dependent in the hospital if the hospitalisation is of at least 3 days.
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, Hysterectomy unless because of malignancy
All types of Hernia, Hydrocele
Fissures &/or Fistula in anus, hemorrhoids/piles
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
Ditto's Take
◦ ◦
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
R
Riya Sharma
The 100% reset benefit is a fantastic safety net. No worries about multiple claims in a year.
R
Rohan Verma
Wellness program is great! Redeemable points and personalized health coaching through their app is very useful.
S
Saanvi Gupta
Air ambulance cover included gives extra security for critical situations.
V
Veer Joshi
The group policy with same name has disadvantages, so had to be careful to pick the retail one.
S
Soham Khan
Premiums can be steep if you go for higher coverage or add-ons like maternity or international coverage
S
Shiv Patel
Flexible add-ons allow customization according to needs. Lifelong renewability is also good.
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Frequently Asked Questions
Does Health Shield 360 Retail 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 1-2 year waiting period for any pre-existing disease you may have while buying the policy.
Does Health Shield 360 Retail have room rent restrictions?
Does Health Shield 360 Retail offer a restoration benefit?
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