ICICI Lombard General Insurance

ICICI Lombard Elevate

Plain-English breakdown of the plan — every field a shopper actually needs before clicking buy. Compiled from public ICICI Lombard brochures and policy wordings. Always confirm against the official PDF below.

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Trust at a glance

ICICI Lombard — IRDAI FY 2024-25

Verified

Claim Settlement Ratio: 85.82%
Incurred Claim Ratio: 82.24%
Complaints / 10,000 claims: 14
Network hospitals: 7,200

Source: IRDAI Annual Report FY 2024-25 · UIN 115PolicyPlain earns no commission · numbers shown verbatim

Plan details

Every field, in one place

Sum insured options: ₹5L · ₹10L · ₹15L · ₹25L · ₹50L · ₹1Cr · ₹3Cr · ₹10Cr · ₹30Cr
Pre-existing disease (PED) waiting: 36 months
Pre-existing covered: Covered after PED waiting period
Co-payment: No copay published
Room rent: No cap
Restoration of sum insured: Unlimited (subject to clauses)
No Claim Bonus (NCB): 100% per claim-free year
Cashless network: 7,200 hospitals (insurer disclosure)
Free-look cancellation window: 30 days
Premium grace days: 30 days
IRDAI UIN: Not confirmed — verify on irdai.gov.in
Last verified: 2026-06 · third party aggregator

Honesty note: Elevate is the recent rebrand of ICICI Lombard's flagship retail health plan; disease-wise sub-limit list not confirmed against policy wording.

Indicative premium

Order-of-magnitude only — NOT a quote

Age	Sum insured	Approx annual premium
35	₹10L	~₹17,000/yr
45	₹10L	~₹24,000/yr

Indicative figures vary by city, family member count, medical loading and policy term. Always confirm on the insurer's premium calculator.

Known exclusions

What this plan typically does NOT cover

Cosmetic surgery (non-reconstructive)
Substance abuse, self-inflicted injury
Adventure / professional sports
Treatment outside India (unless rider opted)
Sleep apnoea / chronic fatigue without supporting diagnosis

Known traps

The fine print that decides claim outcomes

Disease-wise sub-limits can cap claim well below headline SI — read sub-limit annexure carefully.
Cashless only at Preferred Provider Network (PPN) on some variants — non-PPN routes to reimbursement.
Power Booster (NCB) caps at 100% of base SI cumulatively.
Reset Benefit triggers AFTER partial / full base SI exhaustion within the same policy year.
Cumulative bonus is forfeited on claim above a threshold — re-read clause before claiming a small amount.

How to claim

Cashless vs reimbursement — the steps

1Notify insurer. Within 24 hours of emergency admission or 48-72 hours for planned hospitalisation. Use ICICI Lombard's helpline or app — keep the reference number.
2Cashless: Pre-authorisation form filled by hospital, sent to ICICI Lombardvia the hospital's TPA desk. Approval typically 4-6 hours during business; longer overnight. If your hospital is OUT of network (or PPN-only), you'll be on reimbursement.
3Reimbursement:Pay hospital out-of-pocket, then submit claim form + original bills + discharge summary + investigation reports + KYC. Insurer's IRDAI-mandated turnaround is 30 working days from receipt of complete documents.
4Watch for deductions. Room rent above your eligible category triggers proportionate deduction across the WHOLE bill, not just room rent. Sub-limits on cataract / modern treatment apply even when total SI is far higher.
5If denied: Ask for a written denial citing the exact clause. Internal grievance redressal first, then IRDAI Bima Bharosa or the Insurance Ombudsman.

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