PolicyPlain

ICICI Lombard General Insurance

ICICI Pru iProtect Smart CI Rider

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.

critical illnessindividual
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Trust at a glance

ICICI Lombard — IRDAI FY 2024-25

Verified
Claim Settlement Ratio
85.82%

FY 2024-25

Incurred Claim Ratio
82.24%

% of premium paid as claims

Complaints / 10,000 claims
14

Lower is better

Network hospitals
7,200

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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
₹10L · ₹25L · ₹50L · ₹1Cr
Pre-existing disease (PED) waiting
48 months
Pre-existing covered
Covered after PED waiting period
Co-payment
No copay published
Room rent
No cap
Restoration of sum insured
Not available
No Claim Bonus (NCB)
Variant-specific / not single value
Cashless network
7,200 hospitals (insurer disclosure)
Free-look cancellation window
15 days
Premium grace days
30 days
IRDAI UIN
Not confirmed — verify on irdai.gov.in
Last verified
2026-06 · third party aggregator

Honesty note: iProtect Smart CI is offered by ICICI Prudential Life (not ICICI Lombard). Trust card maps to ICICI Lombard as the closest IRDAI entry — confirm provider before purchase.

Indicative premium

Order-of-magnitude only — NOT a quote

AgeSum insuredApprox annual premium
35₹25L~₹4,500/yr
45₹25L~₹8,000/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

  • Conditions not in the 34 listed illnesses
  • Death within 30-day survival period
  • Pre-existing diagnosis before policy issue (subject to PED wait)
  • Self-inflicted injury, substance abuse
  • Congenital diseases

Known traps

The fine print that decides claim outcomes

  • This is a RIDER on the iProtect Smart term plan, NOT a standalone CI policy.
  • Lumpsum paid once per illness, but the base term plan continues.
  • 30-day survival period.
  • Cancer cover has separate clauses for minor vs major / metastatic cancer.
  • Premium varies by smoking status and medical history.

How to claim

Cashless vs reimbursement — the steps

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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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