ICICI Lombard Elevate with Jumpstart Rider

ICICI Lombard General Insurance Company offers a robust health insurance plan known as Elevate, supplemented by the Jumpstart Rider add-on for improved coverage. 

This plan offers comprehensive coverage with a large number of advantages and features tailored to meet your remarkable medical care needs, allowing you to focus on your well-being without stressing over excessive medical costs. It's a brilliant decision for those looking for both cost-effective and comprehensive health insurance coverage, balancing affordability with extensive features and benefits. If you opt for the Jumpstart Rider along with ICICI Lombard’s Elevate Plan, you can get coverage for pre-existing diseases like diabetes, asthma, hypertension, hyperlipidemia, and obesity beginning from day 31. 

Rather than other comparable items on the market, this plan is not only cost-effective but also covers numerous expenses such as consumables, bariatric surgery, maternity expenses, outpatient department (OPD) expenses, along hospitalisation-related costs. Additionally, it provides the flexibility to reduce the waiting period for pre-existing diseases (PED) to 2 years or 1 year and for specific diseases to 1 year. Nonetheless, a prominent disadvantage is the inability to pay premiums on a monthly basis under this plan. Furthermore, our research indicates that while the insurer has received fewer claim settlement complaints, there is a higher number of complaints related to policy purchases.

What are the benefits offered by the  ICICI Lombard Elevate with Jumpstart Rider?

• In-patient hospitalisation coverage: The  ICICI Lombard Elevate with Jumpstart Rider provides coverage for the costs connected with in-patient hospitalisation. These expenses allude to the costs that emerge when you are admitted to a hospital for a length surpassing 24 hours, such as the costs of your hospital room, nursing care, consultations, prescription medications, ICU charges, and some other significant costs. The policy provides in-patient hospitalisation coverage for both room rent and ICU rent. There is no limit for ICU, but the room rent limit is available as an add-on through in-patient coverage. Further, note that expenses for automation machines used in peritoneal dialysis will not be covered for inpatient treatments. 
• Pre-hospitalisation coverage: Pre-hospitalisation expenses incorporate costs like checkups, lab tests, X-rays, and CT scans incurred before hospitalisation. However, these costs are covered by the insurance agency, provided that they are directly related to the condition leading to your hospitalisation and are part of your in-patient hospitalisation claim. The ICICI Lombard Elevate with Jumpstart Rider covers all your pre-hospitalisation expenses for 90 days up to the sum insured. Furthermore, costs for home nursing care are not covered under pre-hospitalisation coverage. 
• Post-hospitalisation coverage:  After being discharged from the hospital, you might confront extra clinical costs known as post-hospitalisation costs. These can incorporate expenses for follow-up check-ups, and other related expenses. To fit the bill for coverage, these post-hospitalisation expenses must be directly linked to the condition responsible for your hospitalisation, and your inpatient hospitalisation claim must be approved. Under the ICICI Lombard Elevate with Jumpstart Rider, you are covered for post-hospitalisation expenses up to the sum insured for 180 days after your hospitalisation. Home nursing care costs are excluded from coverage for post-hospitalisation expenses. Lastly, post-hospitalisation costs for physiotherapy will be covered in the event that it is considered medically necessary and recommended in writing by a doctor.
• Daycare treatment coverage: Daycare treatment refers to medical procedures or surgeries that once required an extended hospital stay but now can be completed within 24 hours, thanks to commendable advancements in clinical innovation. With the ICICI Lombard Elevate with Jumpstart Rider, you can enjoy comprehensive coverage for all the daycare treatments without any financial limit up to the sum insured. Costs for automation machines used in peritoneal dialysis will not be covered for daycare treatments. Lastly, any daycare procedure that requires a period of specialised observation or care afterwards is covered.
• Domiciliary treatment coverage: Domiciliary treatment implies getting medical care at home for severe illnesses or injuries when hospital visits aren't possible, either because of the patient's condition or an absence of accessible hospital beds close by. With the  ICICI Lombard Elevate with Jumpstart Rider, domiciliary treatment is covered up to the sum insured, with 15 illnesses excluded.
• Organ donor coverage: The ICICI Lombard Elevate with Jumpstart Rider also covers organ donor expenses up to their sum insured. However, under organ donor cover, pre and post-hospitalisation expenses for the donor are excluded. Also, costs for complications requiring redo surgery or ICU admission for the donor are not covered.   
• Modern treatment coverage: Modern treatments envelop momentous medical procedures that were once beyond imagination, like immunotherapy, radiotherapy, oral chemotherapy, and more. The ICICI Lombard Elevate with Jumpstart Rider is intended to stay aware of these improvements by covering all modern-day treatments.  What's more, there is no financial limit for any modern-day treatments under the plan. 
• Non-medical expenses coverage: This coverage refers to the cost of consumables, such as nebulisation kits, gloves, oxygen masks, and other urgent things for treatment. The ICICI Lombard Elevate with Jumpstart Rider likewise incorporates coverage for non-medical expenses, with no financial limit up to the sum insured, but you can only include this coverage as an additional feature.  
• No Claim Bonus: You will receive a No Claim Bonus from the insurance company if you file no claims during the course of the policy year.  With the ICICI Lombard Elevate with Jumpstart Rider, you’ll receive a no claim bonus of 100% of the sum insured every claim-free year. There’s no reduction in your accumulated bonus due to claims made in the previous year. Additionally, if you don’t make any claims in a given year, you receive a 20% annual bonus, enhancing your policy’s benefits.
• Super No Claim Bonus: Operating in a similar manner, the Super No Claim Bonus is an enhanced variant of the No Claim Bonus. It is available as an add-on feature with the ICICI Lombard Elevate with Jumpstart Rider. You can accumulate an unlimited bonus with no reduction in your bonus due to claims from the previous year. Additionally, you can earn a 100% annual bonus if no claims are made in the previous year, further enhancing your policy's benefits. 
• Restoration benefit: The restoration benefit is a characteristic that restores your sum insured after you have used it up during a policy year. With the ICICI Lombard Elevate with Jumpstart Rider, you can apply for a refill of coverage an unlimited number of times within a policy year, starting from the first paid claim. The refill is triggered when there is partial exhaustion of the no claim bonus and the sum insured. It covers any illnesses or diseases. When the sum insured is exhausted, the benefit of reinstating the sum insured is available. 

Please keep in mind that the limitations and conditions listed in the benefits section above pertain to a sum insured of Rs. 10 lakhs.

ICICI Lombard Elevate With Jumpstart Rider: Financial Limits

• Room rent limit: It is the highest amount your insurance will cover for hospital room expenses. If you select a room within this limit, there will be no additional charges. However, if you opt for a room with a higher rent than your policy allows, you'll face a proportionate deduction in coverage. With the ICICI Lombard Elevate with Jumpstart Rider, the room rent limit is available as an add-on feature by which you have the freedom to select any room without any restrictions.
• ICU rent limit: The ICU rent limit is the most your health insurance will pay for your stay in the intensive care unit. There is no limit on the ICU rent with the ICICI Lombard Elevate with Jumpstart Rider. In other words, the plan will pay for your ICU stay in full up to the sum insured.
• Copayment: Copayment is a certain percentage of the claim amount that you need to pay from your own pocket. The insurer will then reimburse the remaining costs when this payment is made. The ICICI Lombard Elevate with Jumpstart Rider provides copayment options through 10%/20%/30%/40%/50% (as an option) to the insured.
• Deductible: A deductible is the amount of money you have to pay out-of-pocket before your insurance begins to pay the rest of your health care expenses. There is no deductible option in the ICICI Lombard Elevate with Jumpstart Rider. 
• Limits on surgeries/treatments: It denotes the highest amount that the health insurance coverage will pay for specific medical services or procedures. Some plans set fixed limits for certain procedures, while others offer more flexibility. The ICICI Lombard Elevate with Jumpstart Rider covers the expenses for cataract treatment and joint replacement surgeries up to the sum insured.

Please take note that the aforementioned financial limits apply to a 30-year-old who chooses a Rs. 10-lakh sum insured.

ICICI Lombard Elevate with Jumpstart Rider: Waiting Periods & Exclusions

👉Waiting period

The waiting period is the time frame during which certain illnesses and medical conditions are not covered right after you get a health insurance policy. The length of this period varies between insurance companies. You can only file claims for these specific conditions once the waiting period is over. Here are some of the important waiting periods -

• Initial waiting period: All illnesses, except for those resulting from accidents, come with an initial waiting period of 30 days. During this time, you can't file a claim for hospitalisation unless it's caused by an accident.
• Waiting period for pre-existing conditions: Any illness or medical condition that you have within the 36 months before purchasing health insurance is considered a pre-existing condition. In the ICICI Lombard Elevate with Jumpstart Rider, there is a waiting period of 12 months for any pre-existing condition, but it is available as an add-on. You will not be permitted to submit any claims for costs associated with your pre-existing condition during this waiting period. However, note that this waiting period is excluded for conditions like asthma, hypertension, diabetes,  obesity, hyperlipidemia, and heart disease. 
• Waiting period for specific diseases: In addition to pre-existing ailments, insurers have a list of particular diseases or medical conditions that have waiting periods, irrespective of whether you've experienced them before or not. The waiting period is set entirely by the insurer and does not rely on your state of health at the moment. The ICICI Lombard Elevate with Jumpstart Rider has a waiting period of 12 months for specific diseases, but it is available as an add-on. However, the waiting period for specific conditions such as hypertension, diabetes, and cardiac issues is 90 days unless they are pre-existing conditions. 

👉Exclusions

Exclusions are particular circumstances that health insurance policies do not cover. Here are some of the types of exclusions -

• Standard Permanent Exclusions: As per the Insurance Regulatory and Development Authority of India (IRDAI), every health insurance provider must comply with the list of standard permanent exclusions in all situations. These include -

1. Investigation and evaluation: The process of monitoring and observation during hospital admission. 
2. Rest, rehabilitation, and respite care: Admission to a facility for bed rest without requiring any active treatment or surgery. 
3. Obesity/weight control: Any weight loss surgery, procedures or treatments.
4. Gender reassignment:  Procedures to change to the opposite sex and modify the gender identity.  
5. Plastic/Cosmetic surgery: Any procedure to change the body’s physical features.
6. Profession in hazardous or adventure sports: Expenses for medical treatment arising from participating in professional, adventurous activities like river rafting, mountaineering, scuba diving, and similar pursuits.   
7. Breach of law: Expenses incurred in treating an injured person who has attempted any criminal offence.
8. Excluded providers: Treatment received from medical practitioners or hospitals that are excluded by the insurance company. 
9. Narcotics: Treatment for disorders involving the usage of drugs, alcohol, etc.
10. Treatments in establishments arranged for domestic purposes: Medical costs incurred due to the treatment received in health spas, nursing homes, or such facilities that are operated entirely or partially for domestic reasons. 
11. Dietary supplements purchased without subscription:  Supplements for vitamins and minerals not prescribed by the physicians. 
12. Refractive error: Costs associated with correcting up to 7.5 diopters of refractive defects in order to improve vision.
13. Unproven treatments: Surgeries, medical procedures, or other therapies that lack scientific validation.
14. Expenses related to sterility, birth control, and infertility: Sterilisation, contraception, artificial insemination, and advanced reproductive technologies such as IVF, GIFT, ZIFT, ICSI, and gestational surrogacy.  
15. Maternity expenses: Costs associated with labour, pre-and postnatal care, etc. 

• Additional permanent exclusions: Insurers can impose additional exclusions for specific medical diseases and illnesses beyond the standard permanent exclusions. They might decide to permanently rule out specific illnesses or serious medical issues from your policy if they consider them too risky to cover. 

However, it's important to note that insurers are bound by a specific list of illnesses provided by the IRDAI for which they can implement permanent exclusions. They are not allowed to permanently exclude illnesses or diseases that are not on this list. 

• Non-standard exclusions (Specific exclusions): Beyond the regular permanent exclusions established by the IRDAI, there are non-standard exclusions. Depending on the particular terms and conditions of the policy, these exclusions may differ throughout insurance providers. Here are some of the specific exclusions listed under the ICICI Lombard Elevate with Jumpstart Rider -

1. Injuries or illnesses coming about because of war, invasion, acts of foreign enemies, or comparative threats.

2. Injuries or illnesses brought about by nuclear, chemical, or biological attacks or weapons.

3. Costs for corrective devices, prosthetics, external durable medical equipment (such as wheelchairs and crutches), sleep apnea treatment devices, or cochlear implants, except if required because of a mishap or during surgery.

4. Treatment for diseases or conditions connected with natural teeth and gums, except when expected due to hospitalisation following an accident.

5. Expenses for treatments such as acupressure, acupuncture, and magnetic therapies.

6. Circumcision, unless it is necessary to treat a disease or injury.

7. Venereal and sexually transmitted diseases, with the exception of HIV.

8. Costs associated with screening, counselling, or treatment for external birth defects.

9. Treatment for intentional self-inflicted injuries or attempted suicide by any means.

What to expect in terms of claims experience if you buy from ICICI Lombard General Insurance Company Limited?

• Speed of claims: ICICI Lombard General Insurance Company Limited has settled  99.78% of its claims within 30 days. This ensures that the process of settling your claim will be quick and easy. 
• Claim-related complaints: According to our research, ICICI Lombard General Insurance Company Limited has a complaint rate of 0.11%, which is lower than that of other insurers. This implies that there are fewer claim settlement complaints.
• Claims incurred ratio: The insurer's financial performance for the year is gauged by the claims incurred ratio. It displays the overall number of claims filed by the insurance provider relative to the total amount of premiums received over the course of a given fiscal year. The ratio of claims incurred by ICICI Lombard General Insurance Company Limited is 78.85%.
• Claim settlement ratio: The claim settlement ratio reflects the percentage of claims an insurer has settled in a given fiscal year relative to the total number of claims received. ICICI Lombard General Insurance Company Limited’s claim settlement ratio is 80.97%. 
• Network hospitals: ICICI Lombard General Insurance Company Limited provides access to an extensive network of 9,500+ hospitals. Customers can receive cashless treatment without worrying about cost because of this wide network. 

How is the customer service of ICICI Lombard General Insurance Company Limited?

• Policy purchase-related complaints: According to our research, ICICI Lombard General Insurance Company Limited has received a complaint rate of 0.01% regarding its after-sales service, which is notably higher than that of other insurance companies.
• Response on Toll-Free: Our research indicates that ICICI Lombard General Insurance Company Limited’s response time on toll-free is quick compared to other insurers. 
• Response on Twitter: According to our research, ICICI Lombard General Insurance Company Limited has an average response time on Twitter compared to other insurers.

About ICICI Lombard General Insurance Company Limited

ICICI Lombard General Insurance Company Limited is a joint venture between ICICI Bank Limited and Fairfax Financial Holdings Limited and is a prominent private general insurance provider. Established in 2001 and headquartered in Mumbai, Maharashtra, the company offers a vast portfolio of insurance products, including motor, health, personal accident, crop, fire, and marine insurance. Mr. Bhargav Dasgupta currently serves as the CEO and Managing Director.