Overview
The ICICI Lombard iHealth plan is a versatile health insurance policy offering coverage with sum insured options starting from ₹2 lakh up to ₹50 lakh. It includes benefits such as pre-existing disease coverage after two years [4 years for SI 2L], daycare procedures, AYUSH, pre-post hospitalization cover [30-60 days respectively], ambulance charges [1,500 per event of emergency hospitalisation], and cumulative bonuses [10% increase up to 50%] for claim-free years. The plan allows policyholders to customize coverage with add-ons like hospital daily cash and critical illness benefits, making it suitable for individuals seeking flexible and reasonably priced health protection.
Experts Review
Written by Nikhil Nair
Senior Writer
ICICI Lombard’s iHealth plan stands out for its flexibility and reasonable pricing, catering well to individuals and families looking for customizable health coverage. Its key USP is the option to add benefits like hospital daily cash and critical illness cover, allowing policyholders to tailor the plan to their needs.
The plan offers coverage for pre-existing diseases after a relatively short waiting period of two years [four years for SI 2L], which is competitive in the market. In addition, premiums for iHealth are generally 10-15% lower than comparable plans with similar coverage, making it a cost-effective choice.
However, the plan has some limitations, no domiciliary cover, disease-wise sub-limits on conditions like Cataract.
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
No coverage if you are forced to hospitalize at home, which is a notable gap.
Maternity benefits not offered, which could be a drawback for some.
Doctor consultations are not covered, which is a key feature.
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
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
Your insurance cover won’t be fully available in case you are treated for Cataracts and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
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 - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Add-ons
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 3 days, with a maximum payout of ₹1000 for up to 10 days.
Critical Illness
Paid out as a lump sum of 100% of sum insured for listed Critical illnesses.
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.
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.
Cataract
Benign Prostatic Hypertrophy
Gynecological conditions:
Myomectomy and Hysterectomy (unless because of malignancy)
- Dilatation and Curettage
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
No coverage if you are forced to hospitalize at home.
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
X
Xavier
A decent health insurance plan for general needs.
Y
Yash
Covers the basics well.
Z
Zara
Seems like a standard health policy.
G
Gautam
Claim process could be faster.
E
Esha
Does not have many advanced features.
C
Chetan
A straightforward health insurance option.
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Frequently Asked Questions
Does iHealth 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 iHealth have room rent restrictions?
Does iHealth offer a restoration benefit?
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