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Reviewed by Finzony Finance TeamLast updated:
Elevate is ICICI Lombard's comprehensive health plan for people who want a large sum insured and room to build the policy up with optional covers. You can choose a sum insured from ₹7.5 lakh upward, and there is an unlimited option. The base policy pays for hospitalisation, day care, AYUSH treatment, 90 days of pre-hospitalisation and 180 days of post-hospitalisation costs, and a list of newer treatments such as robotic surgery and immunotherapy. It also adds a Loyalty Bonus of 20% of the sum insured every year you renew, whether or not you claim. If a claim leaves too little sum insured for the next one in the same year, the Reset Benefit refills it up to 100% of the sum insured, though not on your first claim of the year. Much of what sets Elevate apart is optional and priced separately: Power Booster, Infinite Care, Jumpstart for pre-existing conditions, maternity, outpatient cover through BeFit and worldwide hospitalisation. The policy can cover one person or a family, with a tenure of one to five years. An adult can buy it for themselves, and children can be added from 91 days of age. The unlimited sum insured option changes the structure: Reset, Loyalty Bonus and Power Booster do not apply to it.
Resets the sum insured up to 100%, unlimited times in a policy year (not on the first claim), with optional add-ons like Jumpstart and Infinite Care
Finzony treats Elevate as a plan for someone who wants a big sum insured from day one and is willing to pay for add-ons to shape it. The base policy is solid rather than flashy: room rent up to a single private AC room, ICU, doctor and nursing charges, 90 days before and 180 days after the stay, day care, AYUSH, and a list of advanced treatments. The two features that set it apart are the Loyalty Bonus and the Reset Benefit. Both come with conditions that are easy to miss. The Loyalty Bonus (20% a year, capped at 100% of the sum insured) can be used only after the sum insured is exhausted. Reset refills up to 100% of the sum insured but never on the first claim of a policy year, and only for inpatient, day care or AYUSH claims. The unlimited sum insured option gives up Reset, Loyalty Bonus and Power Booster altogether, so the word unlimited does not mean more of everything. On waiting periods the plan follows the usual retail clocks: 30 days for a new illness, 36 months for a pre-existing disease and 24 months for a named list of procedures. Diabetes, hypertension and cardiac conditions carry their own 90-day wait unless you declare them as pre-existing and the insurer accepts them. Jumpstart can cut the pre-existing wait to 30 days for six listed conditions, but it has to be kept for three continuous years. Maternity, outpatient visits, worldwide cover, air ambulance and critical illness are not part of the base policy.
ICICI Lombard Health Insurance
Key Insights
Founded
2001
ICICI Lombard Health Insurance was established 25 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
86% CSR, calculated as a 3-year average
ICICI Lombard Health Insurance settles 86% of all claims it receives.
Network Hospitals
10,700+
ICICI Lombard Health Insurance has a network of 10,700+ hospitals, ensuring wide accessibility and convenience for policyholders.
If earlier claims in a policy year leave too little sum insured, ICICI Lombard resets up to 100% of the sum insured for later claims, as many times as needed in that year. It counts the accrued Loyalty Bonus, Power Booster and Inflation Protector when it checks whether the sum insured is short. On a floater, the reset is shared by the family.
It is not triggered by the first claim of the year, applies only to inpatient, day care and AYUSH claims, does not work outside India, and unused reset is not carried forward. The unlimited sum insured option does not get it.
At the end of each policy year ICICI Lombard credits 20% of the expiring or renewed sum insured (whichever is lower) to the next year, whether or not you claimed, as long as the policy is renewed without a break. The total cannot go above 100% of the sum insured, and on a floater the bonus is shared.
The bonus can be used only when the sum insured is completely exhausted. If you reduce the sum insured at renewal, the bonus is cut in the same proportion. It does not apply to an unlimited sum insured.
Inpatient treatment covers room rent up to a single private AC room, ICU charges, nursing, doctor fees, anaesthesia, blood, oxygen, operation theatre charges, medicines, consumables (outside the non-payable list), prosthetic devices used during surgery on written advice, and investigations linked to the admission.
If you take a room above the category in your schedule, associated expenses such as nursing, OT and doctor fees are paid pro rata. ICU charges are not cut, and no cut applies where the hospital does not bill by room category.
Day care procedures are covered without a 24-hour stay. The base policy also lists newer treatments: robotic surgery, oral chemotherapy, monoclonal antibody immunotherapy, stereotactic radiosurgery, deep brain stimulation, intravitreal injections, balloon sinuplasty, bronchial thermoplasty, HIFU and uterine artery embolisation, laser prostate vaporisation, stem cell therapy for bone marrow transplant, and intra-operative neuro monitoring.
Medical costs for the same condition are covered for 90 days before admission and 180 days after discharge, provided ICICI Lombard has accepted the inpatient, day care or AYUSH claim. Post-hospitalisation can include physiotherapy when it is medically necessary and prescribed.
Pays one claim of your choice in your lifetime without limit on the sum insured. Before the cover can go to zero, the sum insured, Loyalty Bonus, Power Booster and Inflation Protector are used in that order.
You must opt for it in the first 2 policy years, keep it until a claim is made, and it cannot be bought again afterwards. It does not apply to the unlimited sum insured option or to worldwide claims. Room category is capped at a single private room unless you have Room Modifier.
Adds a bonus of 100% of the expiring or renewed sum insured each year, claim or no claim, and the bonus can keep building up without the 100% cap of the base Loyalty Bonus.
Conditions or treatments that the policy clearly says it will not cover.
The conditions and procedures below sit behind the 24-month specified disease and procedure wait, even if they begin after the policy starts. Accident claims are not held to this wait, and if one of them is also a pre-existing disease, the longer wait applies. The list follows ICICI Lombard's Elevate page; the policy wording is the final reference.
Insurer
ICICI Lombard Health Insurance plans and claim process
Yes, with limits. ICICI Lombard resets up to 100% of the sum insured when earlier claims in the same policy year have used it up, as many times as needed. It is not triggered by the first claim of the year, applies only to inpatient, day care and AYUSH claims, does not work outside India, and unused reset is not carried into the next year. The unlimited sum insured option does not get it.
Loyalty Bonus is part of the base policy and adds 20% of the sum insured every year you renew, up to 100%. Power Booster is an optional cover that adds a bonus of 100% of the sum insured each year and can build up without that 100% cap. Both are credited whether or not you claim, and both can be used only after the base sum insured is exhausted. Power Booster cannot be taken together with Power Booster Plus.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official ICICI Lombard Health Insurance website before purchasing.
Contact Details
1800 2666
Headquarters: ICICI Lombard House, 414, Veer Savarkar Marg, Near Siddhi Vinayak Temple, Prabhadevi, Mumbai - 400025, Maharashtra, India.
The aforementioned ratios have been averaged over three years (FY24-FY26)
If you drop it at renewal, the accumulated bonus goes to zero. It cannot be taken together with Power Booster Plus, and it works under the same use-only-after-exhaustion rule as the Loyalty Bonus.
Covers asthma, diabetes, hypertension, hyperlipidemia, obesity and coronary artery disease (angioplasty done more than a year earlier) from day 31 of the first policy start, if you disclose the condition and ICICI Lombard accepts it.
Once chosen it has to be kept for 3 continuous policy years. A raised sum insured at renewal carries a fresh 30-day wait on the increase. It does not apply to worldwide claims.
Lets you shorten the 36-month pre-existing disease wait (to 24 or 12 months in ICICI Lombard's terms). Separate options also exist for specific illnesses, maternity and worldwide cover.
The reduction and its premium depend on your quote and policy schedule.
If you disclose asthma, diabetes, hypertension, hyperlipidemia, obesity or coronary artery disease and it is accepted, you get health tracking, a dietician, lifestyle counselling and 2 diagnostic check-ups 6 months apart, on a cashless basis.
Available to insured people aged 18 or above, and the check-ups are booked through the app or the toll-free number.
Pays maternity expenses up to 10% of the sum insured, capped at ₹1 lakh, for up to 3 deliveries or terminations in a woman's life between ages 18 and 50, including prenatal costs and 30 days of postnatal care on an inpatient basis. New Born Baby Cover and vaccination cover (the lower of 1% of the sum insured or ₹10,000) can be added when maternity cover is in force.
Maternity Benefit is for family floaters only and has a 24-month wait from the date it is opted. Ectopic pregnancy is claimed under inpatient cover instead.
Cashless outpatient benefits through the IL TakeCare app, in seven plans (A to G): 1 to 12 consultations, ₹500 to ₹7,500 each for routine diagnostics and for pharmacy, up to 12 physiotherapy sessions, and counselling and diet sessions (unlimited on the top plans).
Can be bought only up to age 65 at first issuance, with a 30-day wait. ICICI Lombard's website also lists an OPD+ rider; check which one your quote offers.
Covers hospitalisation abroad up to ₹3 crore on top of the base sum insured, on a cashless basis only, for a stay of up to 45 days per trip and 90 days in a policy year.
Age 65 or below and an Indian resident at issuance. A 2-year wait applies (none for emergency care), and planned treatment needs 7 days' prior intimation and approval.
Pays the non-payable items listed in Annexure II once an inpatient or day care claim is accepted.
It draws on the sum insured and is not available outside India.
Raises the sum insured at each renewal in line with the previous year's consumer price inflation, on a cumulative basis.
If you opt out at renewal, the increase built up so far is lost.
Pays a lump sum on first diagnosis of one of 20 listed critical illnesses, such as cancer of specified severity, heart attack, stroke, kidney failure needing dialysis and major organ transplant.
For ages 18 to 50 at first issuance, up to ₹50 lakh, payable once in your life, with a 90-day wait. It does not pay if the illness arises from a pre-existing disease.
A women-focused add-on with in-person and online gynaecologist consultations, diagnostic tests, PCOS and hormonal care tracking, early detection tests such as PAP smear and ultrasound, and plans built around life stages from growing up to menopause.
The wording says it cannot be opted together with the Maternity Benefit add-on. Plan contents and limits are in the policy schedule.
Lets you move to a higher or lower hospital room category than the one in your schedule without the pro-rata deductions that normally apply.
Air ambulance covers a life-threatening emergency transfer to a suitable hospital in India after an accepted inpatient claim. Nursing at Home pays up to ₹2,000 a day for up to 10 days. Convalescence pays ₹20,000 once a policy year if you are hospitalised for 10 days or more. Compassionate Visit pays an economy ticket for a family member if your stay passes 5 days, up to ₹20,000 a year.
A once-a-year health check-up for each adult, up to the lower of 0.5% of the sum insured or ₹5,000, with the package depending on the sum insured.
Cashless only, booked through the app or the toll-free number. Unused benefit is not carried forward.
You can share part of each claim (co-payment) or bear a deductible in return for a lower premium, and Network Advantage gives a discount for treatment at network hospitals. ICICI Lombard lists these options without extra premium.
The exact discount depends on the option you pick; check the quote and policy schedule.
Allows a hospitalisation claim for a stay shorter than the standard 24 consecutive hours.
The base policy needs a 24-hour stay. Conditions of this add-on are in the policy wording.
Yes, after a 36-month wait for conditions you declare and ICICI Lombard accepts. The waiting period reduction option can shorten it, and Jumpstart brings it to 30 days for asthma, diabetes, hypertension, hyperlipidemia, obesity and coronary artery disease with angioplasty done more than a year earlier. Declare every condition when you buy the policy.
Room rent is covered up to a single private air-conditioned room. If you take a costlier room, associated expenses such as nursing, operation theatre and doctor fees are paid pro rata, though ICU charges are not cut. The Room Modifier add-on lets you change the room category.
Not in the base policy. The optional Maternity Benefit pays up to 10% of the sum insured, capped at ₹1 lakh, is available only on a family floater, has a 24-month wait from the date you opt for it, and covers up to three deliveries or terminations in a woman's life between 18 and 50. Newborn and vaccination cover are further add-ons linked to it. The Elevate HER add-on cannot be taken together with the Maternity Benefit.
No. The base policy covers hospitalisation and day care, not routine doctor visits. Outpatient-style cover comes from the optional BeFit cover: consultations, diagnostics, pharmacy, physiotherapy, counselling and diet sessions in seven plans, cashless through the IL TakeCare app, with a 30-day wait and an age limit of 65 at first issuance. ICICI Lombard's website also names an OPD+ rider, so check which one your quote shows.
It removes the cap on the base sum insured, but on that option you get no Reset Benefit, no Loyalty Bonus, no Power Booster and no Infinite Care. Compare it with a high fixed sum insured, which keeps those features.
An adult aged 18 or above can buy for themselves and family, and ICICI Lombard lists adults up to 125 years. You can add a spouse and parents. Dependent children from 91 days to 30 years can be covered, and children aged 91 days to 5 years are covered only on a family floater. The tenure can be one to five years.
ICICI Lombard says it responds to a complete pre-authorisation request from a network hospital within 1 hour and gives final approval within 3 hours of the hospital's discharge request. Ask the hospital to send the request at least 48 hours before a planned admission, or within 24 hours in an emergency. Non-medical items are yours to pay unless you have Claim Protector.
The free-look period is 30 days from receiving the policy document. If you cancel, the premium is refunded after deducting the proportionate risk premium, medical examination costs and stamp duty. The renewal grace period is 30 days (15 days if you pay monthly). If you miss it, you lose continuity benefits, including credit for pre-existing diseases.