iHealth Plus (Complete Health Insurance) in one table
| Insurer | ICICI LOMBARD General Insurance Company Limited |
|---|---|
| Sum insured | ₹3 lakh to ₹3 crore |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What iHealth Plus (Complete Health Insurance) covers
These are the terms that decide what you are actually paid when you claim. Room rent, co-pay and restoration do more to shape a settlement than the sum insured does, and they are read from ICICI Lombard's own policy wording.
| Feature | This plan | What good looks like |
|---|---|---|
| What kind of plan this is | Indemnity health insurance. It reimburses hospital bills up to the sum insured. | Read this first |
| Co-payment | None if you are treated in your own zone or a cheaper one. 8% or 16% of every claim if you are treated in a costlier zone than the premium you paid. A voluntary co-payment can also be chosen for a lower premium | No Co-payment |
| Room Rent Limit | Room rent charges up to a single private room. A higher category triggers a proportionate deduction on the associated medical expenses | No room rent capping |
| Disease sub-limit | Cataract is capped at 10% of the sum insured, up to ₹1 lakh per eye. No other disease sub-limits | No sub-limit |
| Loyalty Bonus | 20% of the annual sum insured a year, up to a maximum of 100%, with no reduction even in the event of a claim | 50% each year (Minimum upto 100%) |
| Reset Benefit | Up to 100% of the sum insured – once a policy year for the same illness, and unlimited times for a different illness | 100% restoration once in a year |
| Pre-Hospitalization | 30 days | At least 60 days |
| Post-Hospitalization | 60 days | At least 120 days |
| Consumables | Not in the base cover – the Claim Protector optional cover makes the non-payable list payable up to the sum insured | Consumables covered |
| Day Care Procedures | Covered up to the sum insured | Covered without a capped list |
| Domestic Air Ambulance | Covered up to the sum insured, built into the base plan | Included |
| Home Care Treatment | Up to 5% of the sum insured, capped at ₹25,000 | Covered up to the sum insured |
| AYUSH Treatment | Covered up to the sum insured, as an in-patient | Included |
| Entry age | From 6 years with no maximum entry age. Children aged 3 months to 5 years only on a floater, and a dependent child can stay until 20 | No maximum entry age |
iHealth Plus (Complete Health Insurance) add-ons you can buy with it
Each of these costs extra and each has its own conditions. Some are genuinely worth it; several exist to patch a gap in the base plan. Ask what each one adds before it goes on your quote.
iHealth Plus (Complete Health Insurance) discounts you can ask for
Published discounts on this plan. Most are applied at quote stage rather than offered, so it is worth naming the ones you qualify for. Every figure is a ceiling, not a promise - what you actually get depends on the case.
| Discount | Worth | When it applies |
|---|---|---|
| Tenure discount | Up to 10% or 15% | 10% off the second year's premium on a 2-year policy, and 15% off the third year's premium on a 3-year policy. |
| Zone discount | Up to 8% or 16% | 8% off the Zone A premium in Zone B and 16% in Zone C. Rest-of-NCR districts carry an 8% loading instead. The saving comes with a co-payment if you are treated in a costlier zone. |
| Pneumococcal vaccination | Up to 2.5% | Where every adult on the policy has had the conjugate pneumococcal vaccine in the year before the policy starts. It continues for as long as you renew. |
| Voluntary co-payment | Varies | Agree to bear a share of every claim and the premium falls accordingly. |
| Voluntary deductible | Varies | Agree to fund the first slice of each year's claims yourself in exchange for a lower premium. |
From the ICICI Lombard Complete Health Insurance prospectus. Zone pricing cuts the premium but brings a zone-based co-payment with it.
iHealth Plus (Complete Health Insurance) waiting periods: when each part of the cover starts
Waiting periods run from the day cover began, not from the day you fall ill, and they run in parallel rather than one after another.
| Initial Waiting Period | 30 days |
|---|---|
| Diabetes, hypertension and cardiac conditions | 90 days, unless they are declared pre-existing conditions |
| Specific Illness | 24 months |
| Pre-Existing Disease | 24 months |
The named illnesses that wait 24 months
Payable once the policy has run 24 months without a break; an accident is covered from day one. This list is indicative – the policy wording carries the full set.
iHealth Plus (Complete Health Insurance) exclusions: what the plan will not pay for
Every policy carries exclusions, and they are the clauses people read for the first time at claim stage. These are the ones worth knowing before you buy.
Where iHealth Plus (Complete Health Insurance) falls short
No plan is right for everyone, and a page that only lists strengths is not much use to you. These are the gaps we would raise on a call before recommending it.
iHealth Plus (Complete Health Insurance) questions, answered
What is the pre-existing disease waiting period?
24 months of continuous coverage, for conditions you declared and the insurer accepted. That is a year shorter than the 36 months many plans use and shorter than ICICI Lombard's own Elevate. If you moved from another insurer, the period already served there is set off under the portability rules.
Does where I am treated change what I get paid?
Yes. Premium is set by zone, and a co-payment applies on every claim if you are treated in a zone above the one you paid for. A Zone B policyholder treated in Zone A bears 8%; a Zone C policyholder bears 8% in Zone B and 16% in Zone A. Zone A and Zone D policyholders have no zone co-payment at all. If you expect to travel to Delhi or Mumbai for surgery, ask for the higher-zone premium up front.
I have diabetes or high blood pressure. What should I watch for?
Expenses related to hypertension, diabetes and cardiac conditions are excluded for the first 90 days from the policy start date unless they are declared pre-existing conditions. If you declare them and they are accepted, the ordinary 24-month pre-existing wait applies instead. Either way, disclosure is what protects you – it is the single most common reason an early claim is turned down.
How does the Reset Benefit work here?
Two different rules apply depending on what put you back in hospital. For a different illness, the sum insured resets an unlimited number of times in the policy year. For the same illness, it resets once. The reset triggers when your annual sum insured, plus any loyalty bonus, super loyalty bonus and sum insured protector, is not enough because of earlier claims that year.
Is the Loyalty Bonus a no-claim bonus?
No. The wording gives a cumulative bonus of 20% of the annual sum insured up to a maximum of 100% if the policy is continuously renewed, and says there is no reduction to the bonus even in the event of a claim. The optional Super Loyalty Bonus adds 50% a year on top, building to 100% on covers of ₹5 lakh to ₹10 lakh and 200% on larger ones.
Are consumables covered?
Not as standard. Claim Protector is an optional cover that makes the items on IRDAI's excluded list payable up to the annual sum insured once an in-patient or day-care claim has been accepted. Without it, those charges are deducted from your settlement, and on a surgical admission they can easily run into tens of thousands.
Understand the terms before you commit
A plan page tells you what this policy does. These explain why each term matters and what it costs you when it is missing.
Other ICICI Lombard plans we have read
ICICI Lombard files these separately, and the terms differ between them. If you are choosing within the range, compare the waiting periods and the exclusions rather than the sum insured.