complete health insurance policy (individual) from icici lombard
DESCRIPTION
This presentation explains about the various features and benefits of availing Individual health insurance policy (for self and family) from ICICI Lombard.TRANSCRIPT
Personal Health
Insurance from ICICI LombardCall +91
9900113820 for more information
Who said I need health Insurance?
I don’t fall sick!! Why should I take an Health
Insurance??
Health insurance is needed more now than ever before because of -
Why Health Insurance?
Skyrocketing medical costs
Need for routine
medical check ups and care
Expensive trips to
specialist doctors
Possibility of hospitalization and treatment
Benefits of Health Insurance from ICICI Lombard
Pre-existing disease covered (after 2 years)
Day care surgeries / treatments
covered
Free yearly medical checkup coupons for up to
2 people
Cashless Treatment at
Specialty Hospitals
Optional Maternity cover
available
Outpatient treatment covered
Scope/ Coverage
What illness will you be covered for ?? And
what will you not be covered !
Scope of cover
Disease/ Injury Treated medically/
surgically By Hospitalisation/
Domiciliary hospitalisation
At Nursing home/ hospital in India as in-patient
Age limit 90 days – 80 years
Pre hospitalisation Relevant medical
expenses 30 days prior to hospitalisation
Post hospitalisation Relevant medical
expenses 60 days after hospitalisation
Compensation payable
Reasonable and necessarily incurred Room expenses in
hospital/ nursing home
Nursing expenses Medical
practitioner fee
Treatment costMedicines/ diagnostic
cost Blood/ oxygenCost of pacemakerOperation theatre
chargesSurgical appliancesDialysis,
chemotherapy, radiotherapy
Compensation payable contd.…
Pre and post hospitalisation expenses
Max of SI Surgical operation Manual operative
procedure for Deformity Defect correction Diagnosis cure Prolongation of life
Hospitalisation
Min period of 24 hrs Time limit not applicable for specific
treatment Dialysis Chemotherapy Tonsillectomy Day Care Cataract
Pre & post hospitalisation
Pre hospitalisation Relevant medical expenses 30 days prior
to hospitalisation Post hospitalisation
Relevant medical expenses 60 days after hospitalisation
Any one illness Continuous Period of Illness Relapse within 45 days of the earlier
treatment
Domiciliary hospitalization Treatment exceeding 3 days at
Residence Serious condition of patient
does not allow removal to hospital
Lack of accommodation in nursing home
Pre / post hospitalisation expenses not covered
Specified diseases excluded - Asthma/ Diabetes/ Dysentery/ Hypertension/ Flu/ Epilepsy/ Arthritis
My No Service Areas..
Ok.. Lot of things are covered…Is there
anything left that we don’t cover???
First year exclusions
CataractBenign prostratic hypertrophyHysterectomy for menonhargia or fibromyomaHernia/ hydroceleCongenital internal diseaseFistula in anus/ pilesSinusitis & related disorder
General exclusions
War/ war group Nuclear perils Plastic surgery Spectacles/ contact lens/
hearing aid Dental treatment Convalescence/ general
debility Sterility/ venereal
disease / circumcision Intentional self injury
General exclusions contd.…
Use of intoxicating drugs/ alcohol
Aids Diagnostic/ laboratory
expenses not consistent with treatment
Vitamins/ tonic inconsistent with treatment
Pregnancy Naturopathy
Mediclaim…No Money
What if you have an emergency. Can we
provide service without cash??
Cashless mediclaim
Claim handled by both ICICI Lombard Health care & Outside TPA depending upon Client
Planned treatment in notified hospital Inform TPA & get treatment post
approvalCashless / Hassle free claims
settlement Emergency – What to do???
Give TPA membership no Intimate TPA & approvalCashless / Hassle free claims
settlement
Reimbursement
Process of Reimbursement and claims is giving me
Nausea.. I think I am sick..
Reimbursement – mediclaim
Planned / Emergency treatment in non-notified hospital Notice to TPA & approved Submit
Duly completed claim form Bills, receipts and discharge
certificate/card from the Hospital
Bills from Chemists supported by proper prescription.
Test reports and payment receipts
Settlement within a week on complete submission
Thank you
Call +91 9900113820 for more information