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Reviewed by Finzony Finance TeamLast updated:
Saral Suraksha Bima is the standard personal accident policy that IRDAI made mandatory for general and health insurers, so the covers and wording are the same whichever insurer you pick and only the price differs. ICICI Lombard's version pays 100% of the sum insured on accidental death and on permanent total disablement, and a percentage of it for permanent partial disablement, with one sum insured shared across the three base covers. You can choose a sum insured from ₹2.5 lakh to ₹1 crore in multiples of ₹50,000. The policy runs for one year and is renewed every year. Three optional covers can be added: temporary total disablement, which pays a weekly amount while you cannot work, accidental hospitalisation expenses up to 10% of the base sum insured, and an education grant for dependent children. Each insured person has their own sum insured, because ICICI Lombard does not offer a floater. The policy covers accidents only, not illness.
IRDAI standard personal accident policy with uniform cover across insurers
Finzony sees Saral Suraksha Bima as a plain, regulator-designed accident cover, and that is its strength. The wording is standard, so you can compare insurers on price alone, and there is a printed scale for partial disablement, so you can see what each type of loss pays before you buy. It also has features many accident plans lack: a cumulative bonus of 5% for every claim-free year up to 50%, no premium loading on renewal because of your own claims, and fixed benefits that are paid independently of other policies you hold. For people who want a basic accident safety net on top of a health policy and a term plan, it is a sound, low-cost choice. The limits are just as standard. A single sum insured is shared across death, permanent total disablement and permanent partial disablement, so a partial disablement payout reduces what is left. The cover ends when 100% of the sum insured is paid, and the policy cannot be renewed after that. The optional temporary disablement cover pays only if you are disabled for more than four consecutive weeks, and hospitalisation cover is optional, capped at 10% of the base sum insured and valid for treatment in India only. Read the exclusions with care. Adventure sports are excluded when you take part as a professional, and accidents on board an aircraft are covered only as a passenger on a scheduled airline. It is a no-frills product. If you want extras such as broader adventure sports cover or loan protection, look at a non-standard accident plan.
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.
Pays 100% of the sum insured to the nominee if the insured dies because of an injury from an accident during the policy period, provided the death happens within 12 months of the accident.
The benefit is payable even if the death happens after the policy period ends, as long as it is within 12 months of the accident.
Pays 100% of the sum insured for total and irrecoverable loss of sight of both eyes, physical separation or loss of use of both hands or both feet, or of one hand and one foot, loss of sight of one eye together with loss of use of a hand or foot, or an injury that permanently and totally stops the insured from doing any job or occupation.
The disablement must occur within 12 months of the accident.
Pays a percentage of the sum insured. One entire hand, one entire foot or sight of one eye pays 50%, and loss of use of both ears also pays 50%. Loss of four fingers and a thumb pays 40%, four fingers 35%, and a thumb 25% for both phalanges or 10% for one. An index finger pays 10%, 8% or 4%, a middle finger 6%, 4% or 2%, a ring finger 5%, 4% or 2%, and a little finger 4%, 3% or 2%, depending on how many phalanges are lost. Loss of use of one ear pays 20%, and all toes 20%. A great toe pays 5% for both phalanges or 2% for one, and other toes 1% when more than one toe is lost.
Any other partial disablement is paid as a percentage assessed by an independent medical practitioner. Several disablements together can never pay more than the sum insured.
The base sum insured and cumulative bonus apply together to death, permanent total disablement and permanent partial disablement. There is a single sum insured for all three.
A partial disablement payout reduces what is left for a later claim in the same policy.
The sum insured, excluding bonus already added, goes up by 5% for each claim-free policy year if you renew without a break, up to a maximum of 50%.
A claim reduces the bonus at the same rate it was added. The bonus applies to the three base covers only, is tracked for each insured person separately, and needs renewal within the grace period.
If an accident completely stops you from doing any work you could do before, the policy pays a weekly benefit as set in the schedule until you can return to work. The IRDAI standard rate is 0.2% of the base sum insured a week, for up to 100 weeks per injury, and never more than the sum insured.
It pays only if the disablement lasts more than four consecutive weeks from the date of the accident, and a doctor must certify that it began within 30 days. Once eligible, the benefit counts from the date of the accident. It is paid every quarter, and you must tell ICICI Lombard when you return to work.
Reimburses accident related hospital expenses up to 10% of the base sum insured. It covers room, boarding and nursing, doctor and surgeon fees, anaesthesia, blood, oxygen, operation theatre charges, medicines, diagnostics, ICU or ICCU, internally implanted prosthetics, AYUSH treatment without sub-limits, dental treatment, plastic surgery, day care procedures and road ambulance up to ₹2,000 per hospitalisation.
The policy wording lists no initial waiting period for the base covers. The only waiting condition is on the optional Temporary Total Disablement cover: the disablement must continue for more than four consecutive weeks from the date of the accident. Once that is met, the benefit is paid from the date of the accident for the whole period of disablement. The renewal grace period is 30 days, and no cover is available during the grace period.
Temporary total disablement (optional cover)
The disablement must continue for more than four consecutive weeks from the date of the accident. After that, the benefit is paid from the date of the accident for the whole period of disablement, for up to 100 weeks per injury.
Conditions or treatments that the policy clearly says it will not cover.
Insurer
ICICI Lombard Health Insurance plans and claim process
It is a standard personal accident policy designed by IRDAI. Every general and health insurer offers it with the same covers and wording, so only the premium differs between insurers.
Accidental death and permanent total disablement each pay 100% of the sum insured. Permanent partial disablement pays a percentage set by a printed scale, such as 50% for loss of one hand, foot or eye. All three share one sum insured.
You can choose from ₹2.5 lakh to ₹1 crore in multiples of ₹50,000.
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)
A stay of at least 24 hours is needed, except for day care treatment. Treatment must be in India, and items on the policy's non-payable list are not paid.
After an admissible death or permanent total disablement claim, ICICI Lombard pays a one-time grant of 10% of the base sum insured for each dependent child.
The child must be a full-time student and not more than 25 completed years old. Each optional benefit is paid over and above the base sum insured.
Temporary total disablement, hospitalisation expenses due to accident, and an education grant. Each is paid over and above the base sum insured, and you can add or drop an optional cover at renewal.
Adults aged 18 to 70 can buy the policy. You can also insure your spouse, parents, parents-in-law and dependent children aged 3 months to 25 years.
No. ICICI Lombard does not offer a floater. The sum insured applies to each person, and you can buy separate policies for your family members.
The policy is for one year and is renewed every year. You get a 30-day grace period, but no cover is available during it. The policy cannot be renewed once 100% of the sum insured has been paid for death or permanent total disablement.
Yes, through the cumulative bonus. The sum insured goes up by 5% for every claim-free year if you renew without a break, up to 50%. A claim reduces the bonus at the same rate.
It does not cover illness. Taking part as a professional in hazardous or adventure sports is excluded, and so is intoxication, unless you were not directly responsible for the accident.
You can claim from the policy start date. Report an incident within 30 days and submit the claim within one month after treatment ends. ICICI Lombard has to settle or reject within 30 days of the last document, or 45 days if it investigates, and pays 2% above the bank rate as interest on delays.
For all claims: the claim form, photo ID, and FIR, panchnama or police inquest report where required. For death: the death certificate, post mortem report if done, and the nominee's ID proof or a succession or legal heir certificate. For disablement: the treating doctor's certificate, discharge summary and disability certificate. Hospitalisation and temporary disablement claims need medical papers, and temporary disablement also needs an employer leave certificate and a fitness certificate.
Yes, with 15 days' written notice. The refund is 77.5% of the premium within 30 days, 62.5% from 31 to 90 days, 42.5% from 3 to 6 months, 20% from 6 to 9 months and nothing after that. No refund is paid if a claim has been admitted or lodged. A 15-day free look period applies on new policies.