Overview
The ICICI Lombard Max Protect Premium plan is a high-end health insurance offering designed to provide comprehensive coverage with international treatment options. It offers sum insured options from ₹1 crore to unlimited cover amount, and includes features like unlimited restoration of the sum insured, a loyalty bonus of 20% annually up to 100%, and coverage for advanced treatments such as robotic surgeries and stem cell therapy (up to SI or ₹1 crore, whichever is less). The plan also offers global coverage (up to ₹3 crore or the base cover amount, whichever is less), air ambulance services, and a claim protector feature, which provides coverage up to the cover amount for consumables and non-payable items, enhancing its appeal for those requiring international healthcare access.
Experts Review
Written by Nikhil Nair
Senior Writer
The ICICI Lombard Max Protect Premium plan stands out for its comprehensive coverage and international treatment options, setting it apart from the Classic variant. Its key strengths include global healthcare access, air ambulance services, and a claim protector feature, which provide significant advantages for policyholders seeking treatment abroad or requiring emergency medical evacuations.
The plan has an unlimited cover amount option to ensure robust financial protection against substantial medical expenses, making it suitable for individuals and families with high healthcare needs.
While both Classic and Premium variants offer unlimited restoration of the sum insured and loyalty bonuses, the Premium plan’s inclusion of worldwide coverage (after a waiting period of 2 years), health checkup up to ₹10,000 and a second opinion for critical illnesses (up to the cover amount) and air ambulance services makes it more appealing for frequent travelers or those seeking specialized treatments abroad.
However, room rent restrictions apply to both plans, limiting policyholders to single private rooms in the Classic plan, and any room, excluding suites, in the Premium plan. Additionally, ICICI Lombard’s recent claim settlement performance has raised concerns among prospective buyers.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Premiums are relatively high.
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
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 rooms are okay. Single private rooms are okay. Most rooms are okay unless it’s a suite room — the expensive stuff. Then you’ll have to start splitting the bill.
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/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.
Restoration benefit
Even after you claim part of the cover on one occasion, you will be allowed to claim the full cover any number of times repeatedly if you are hospitalized in the future. All in the same year by the way!!!
Add-ons
Reduction in PED
Recommended
For any illness: Pre existing disease waiting period is modified/reduced from 3 Years to 2 Years.
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 surgeries:
Surgery on tonsils, adenoids and sinuses
Mastoidectomy
Tympanoplasty
Deviated Nasal Septum
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting periodCustomisable
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. This policy also further allows to reduce the PED waiting period to 2 Years for all diseases.
What's missing in the policy
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
S
Shaurya F.
Global coverage is a huge plus! I travel a lot, and this gives me peace of mind for treatments abroad.
K
Kiara V.
Air ambulance and claim protector features are excellent. Shows they've thought about all emergencies.
A
Atharv J.
Unique unlimited sum insured offered.
K
Krishna Y.
It is quite expensive. Only makes sense if you really need the worldwide coverage.
S
Saanvi P.
Room rent restrictions even in a premium plan (no suites) is a bit disappointing.
A
Anika N.
High sum insured and global access make this a truly premium product. Worth the money for peace of mind.
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Frequently Asked Questions
Does Max Protect Premium 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 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does Max Protect Premium have room rent restrictions?
Does Max Protect Premium offer a restoration benefit?
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