ICICI Lombard General Insurance

ICICI Lombard Health Shield

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: ₹2L · ₹5L · ₹10L · ₹15L · ₹25L · ₹50L
Pre-existing disease (PED) waiting: 36 months
Pre-existing covered: Covered after PED waiting period
Co-payment: No copay published
Room rent: Single private AC room
Restoration of sum insured: Once per policy year
No Claim Bonus (NCB): 10% 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: ICICI Lombard rebranded Complete Health as Elevate; Health Shield refers to the legacy / lower-tier offering. Confirm current variant.

Indicative premium

Order-of-magnitude only — NOT a quote

Age	Sum insured	Approx annual premium
35	₹10L	~₹13,000/yr
45	₹10L	~₹18,000/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
Substance abuse, self-inflicted injury
Adventure activities
Treatment outside India
Experimental treatments

Known traps

The fine print that decides claim outcomes

Health Shield is the older entry-tier plan from ICICI Lombard — many buyers should consider Elevate.
Single private AC room category cap — proportionate deduction beyond.
NCB at 10% per claim-free year — slower than competitors.
Disease-wise sub-limits on cataract, hernia and modern treatments.
PPN restriction for cashless on some variants.

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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