AN IDEAL HEALTH SHIELD FOR

YOU & YOUR FAMILY.

Convenient Focuses on Health and Wellness

INTRODUCTION
• A health policy that focuses on well being through preventive
services.

• Through a unique set of solutions, Health Shield 360 meets

your healthcare and wellness needs.
 HEALTH SHIELD 360: KEY FEATURES
KEY FEATURES AND DEFINITIONS

Age limit
Age limit 21 to 70 years for Adults and 91 days to 20 years for children

Hospitalisation Cover
Expenses pertaining to in-patient hospitalisation such as room rent, intensive
care unit charges, surgeon’s and doctor’s fee, anesthesia, blood, oxygen,
operation theatre charges etc. incurred during hospitalisation for a minimum
period of 24 consecutive hours are covered under the basic hospitalisation
cover.

Day Care Surgeries/ Treatments Coverage

Medical expenses incurred while undergoing Day Care Procedures/ Treatment
which require less than 24 hours hospitalisation are covered.

Pre and Post Hospitalisation Expenses

Medical expenses incurred, immediately, 90 days before and 180 days after
hospitalisation will be covered.

In Patient AYUSH Treatment

Expenses for Ayurveda, Yoga and Naturopathy, Unani, Siddha and
Homeopathy (AYUSH) treatment only when it has been undergone in a AYUSH
hospital or in AYUSH Day Care Center.

Unlimited Reset Benefit**

We will reset up to 100% of the base Sum Insured unlimited times in a policy
year in case the Sum Insured including accrued additional Sum Insured (if any),
Super No Claim Bonus (if any) & Sum Insured Protector (if any) is insufficient as
a result of previous claims in that policy year. The reset amount can only be
used for all future claims within the same policy year, not related to the illness
for which a claim has been paid in that policy year for the same person.

Additional Sum Insured (ASI)##

At the time of renewal of this Policy, We will provide an additional sum insured
(hereinafter referred to as “Additional Sum Insured”) of 10% of annual sum
insured of immediately preceding policy year subject to a maximum of 100%
provided that there is no Claim under this Policy during the Policy Year except
as an Out-patient (If opted). This cover will be applicable only within the
geographical boundaries of India.
 Home Health Care
In this benefit we will cover the medical expenses incurred by you on availing
KEY FEATURES AND DEFINITIONS

treatment at home as prescribed by a medical practitioner.

Claim Protector*
In case the customer has opted for this cover, the list of non-payable items shall
become payable in case of a claim.

Additional Sum Insured (ASI) Protector*

At the time of renewal of this Policy, We will provide an additional sum insured
(hereinafter referred to as “Additional Sum Insured”) of 10% of annual sum
insured of immediately preceding policy year subject to a maximum of 100%
provided that there is no Claim under this Policy during the Policy Year except
as an Out-patient (If opted). This cover will be applicable only within the
geographical boundaries of India.

Out-Patient Treatment Cover

Outpatient (OPD) medical expenses covered on cashless and reimbursement
basis.
Maximum limit of Rs 2,500 for SI 5L
Maximum limit of Rs 5,000 for SI 10L
Maximum limit of Rs 10,000 for SI 25L/ 50L/ 100 L

Domestic Road Emergency Ambulance Cover*

Covers road ambulance expenses, incurred to transfer the Insured following an
emergency to the nearest hospital per event of emergency hospitalisation,
provided we have accepted the in-patient claim.
For SI `5L/ 10L = up to a maximum limit of `3,000
For SI `25L/ 50L = up to a maximum limit of `5,000

Maternity Cover*
Medical Expenses incurred for delivery of child, where You and Your spouse,
both are covered under the same family floater Policy and have served the
waiting period of 1 years up to the limit as specified below. This cover will be
applicable only within the geographical boundaries of India.
SI 5L/10L/25L= Maternity limit Rs 50,000 for both normal and C section,
maximum upto 2 events
SI 50L/100L= Maternity limit Rs 100,000 for both normal and C section,
maximum upto 2 events

Above features are applicable only within the geographical boundaries of India.
 PED Covered after 2 years
Pre-Existing Diseases that have been declared at the time of proposal and
accepted by Us will be covered after 2 year waiting period.
KEY FEATURES AND DEFINITIONS

Domiciliary Hospitalisation
We will cover the Medical Expenses incurred in respect of Your Domiciliary
Hospitalization during the Policy Period provided minimum hospitlisation of 3
days.will be applicable only within the geographical boundaries of India.

Donor Expenses
Medical Expenses incurred in respect of the donor for any organ transplant
surgery, provided the organ donated is for the insured person’s use.

Air Ambulance Cover

Air Ambulance expenses incurred to transfer the Insured Person following an
emergency to the nearest Hospital up to Sum Insured on cumulative basis.

Nursing at Home
We will pay you `1000 per day up-to a maximum of 15 days post Hospitalization
for the medical services of a Qualified Nurse at Your residence, provided that
the nurse is employed in a Hospital/Service provider and the engagement of
such Qualified Nurse is certified as necessary by a Medical Practitioner and
relates directly to any Illness or Injury, covered under the Policy.

Super No-Claim Bonus*

In case the customer has opted for this cover, there will be an increase in 50%
of sum insured bonus awarded for every claim free year subject to a maximum
of 100% of sum insured. In the event of a claim in the Policy year, the Super
No-Claim bonus will reduce by 50%.

Compassionate Visit*
We will reimburse the cost of the economy class air ticket incurred by Your
Immediate family from and to the place of origin of such immediate family or the
place of residence of the immediate family up to `20,000. This cover will be
applicable only within the geographical boundaries of India.

Above features are applicable only within the geographical boundaries of India.
 HEALTH SHIELDHEALTH
360 – COVERAGE OPTIONS
SHIELD 360 – COVERAGE OPTIONS
Health Shield 360 offers 4 unique combinations of coverage that will offer a host of benefits to cater to
Health Shield 360 offers 3 unique combinations of coverage that will offer a host
your healthcare needs.
of benefits to cater to your healthcare needs.
COVER COMBINATION
Cover Names
Basic Covers PremiumCOVER
Covers COMBINATION
Advanced Covers Worldwide Cover
Cover Names
Basic Covers Premium Covers Worldwide Cover
Sum Insured 5L, 10L,25L,50L 5L, 10L,25L,50L 5L, 10L,25L,50L 50L/ 100L

Sum Insured 5L, 10L,25L,50L 5L, 10L,25L,50L 50L/ 100L

In-patient Hospitalisation

In-patient Hospitalisation
Day Care Treatment/Surgeries

Day Care Treatment/Surgeries

Pre - Post Hospitalisation

Pre - Post Hospitalisation

In Patient AYUSH Hospitalisation

In Patient AYUSH Hospitalisation

Unlimited Reset Benefit**

Unlimited Reset Benefit

Additional Sum Insured (Cumulative Bonus)##

Additional Sum Insured (Cumulative Bonus)

Donor Expenses

Donor Expenses
Domiciliary Hospitalization

Domiciliary Hospitalization
Domestic Road Emergency Ambulance Cover

Domestic Road Emergency Ambulance Cover

Air Ambulance (Domestic)

Air Ambulance (Domestic)

Home Healthcare

Home Healthcare
Convalescence Benefit

Convalescence Benefit
ASI Protector

360 Well Being Program

Maternity Cover

OPD Cover
New Born Baby Cover

Nursing at Home
OPD Cover

Super No Claim Bonus

Dependent Accommodation

ASI Protector
Nursing at Home

Claim Protector
Claim Protector*

Sum Insured Protector

Compassionate Visit

Compassionate Visit
Sum Insured Protector

Worldwide cover Including India (Hospitalisation)

Super No Claim Bonus*

Road Emergency Ambulance (worldwide including India)

Worldwide cover Including India (Hospitalisation)#

Air Ambulance (worldwide including India)

Air Ambulance (worldwide including India)
 HEALTH SHIELD 360 - DOMESTIC COVERAGES
Domestic coverages offer a range of sum insured to cover your family with multple
options to provide protection against medical and healthcare requirements that suit
your needs.

Unlimited Reset Benifit**

HEALTH SHIELD 360 -

OPD cover
DOMESTIC COVER

Additional Sum Insured

ASI Protector*

Super NCB*

Claim Protector*

Compassionate Visit*
Note : **Reset will be available unlimited times in a policy year in case the Sum insured including accrued Additional Sum Insured (if any) and Super No-Claim Bonus
(if any), Sum insured protector (if any) is insufficient as a result of previous claims in that policy year. Reset will not trigger for the first claim. Reset will not trigger for
same person with same illness for which a claim has been paid in that policy year.
*Optional Covers are available on the selected options under this Policy on payment of addtional premium.
 PREMIUM TABLE (Excluding GST) Basic Coverages
PREMIUM TABLE (Excluding GST) Sum Insured = `5 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K

Basic Coverages
0-25 5,032.43 6,373.22 7,433.57 7,470.70 9,379.12 11,704.59

26-30 5,619.28 6,630.96 7,739.15 8,185.18 9,673.40 12,217.21

31-35 5,611.21 6,622.89 7,731.08 8,169.04 9,657.26 12,201.07

Sum Insured
Sum Insured == 5 Lakhs
5 Lakhs
Sum Sum
Insured
Insured = =
10 10
LakhsLakhs
(PREMIUM EXCLUDING GST)

Age / SI Individual 1A+1K 1A+2K 36-40 2A 6,592.43 2A+1K 7,799.02

2A+2K 8,653.69
Age / SI Individual10,084.92 1A+1K 11,318.88
1A+2K 2A 12,651.27 2A+1K 2A+2K
0-25










 






























 








  








  0-25






























 








  

















 
26-30





















 










 








 








  








 26-30










 










 

















  








 









41-45 6,638.49 7,845.08 8,699.75 10,177.03











 










 
11,411.00








 12,743.39









 

















 
31-35





















 










 








 








  








  31-35
36-40










 




























 








 








  36-40



































 


















41-45










 










 46-50








8,728.71


















  10,655.75









  11,178.37
41-45








14,206.47









 15,473.92


















 16,233.42
 








 









46-50

















 








 








  








 








 46-50


























 




































 








 








 
51-55








 








 








 








 








 
51-55 11,901.17








 
13,189.75 51-55
13,898.50 20,195.80 20,797.40








 21,286.86









 








  
56-60



































 








  








   56-60








 








 








  








 

















 
61-65








  








  








  








 








  








  61-65


























 








 








 








  
56-60 16,888.04 17,567.54 18,554.62








 28,887.47 30,568.88 31,526.97
BASIC COVERAGES

66-70








 








 



































 66-70 


















  

















 










Sum Insured = 10 Lakhs

Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K
Sum Sum
Insured ==
25 25
0-25
Insured LakhsLakhs
6,379.31 7,736.74 8,960.54 Sum Sum
8,946.86 Insured = Lakhs
11,127.75
Insured = 50 50 Lakhs
13,791.69
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K
0-25








 


















26-30








 7,085.51









 









 
8,051.38 0-25
9,333.66








 9,777.12


















 
11,474.40

















  
14,418.75









26-30








 








 








 

















  








 26-30

















  








  

















 









31-35








 

















 








 

















 31-35

















 








  

















 








  
36-40

















 








31-35
 








7,077.44









  8,043.31









   9,325.59
36-40








  9,760.98









  11,458.26









 14,402.61



























  
41-45

















 








 








 








 








  41-45








  








  

















 


















46-50








  








 









36-40








  8,316.36



















9,436.99 46-50
10,430.06








 12,017.67









  








  
13,427.81








14,951.25









  








 
51-55








 








 








 








  








  








 51-55



































  








  








  
56-60








 








 








 

















 








  56-60


























 



























61-65

















  








41-45
 








8,362.42









  9,483.05









 10,476.12
61-65








 12,109.79









  13,519.93









  








15,043.36






 






66-70








  























  











  66-70








 























 











 
46-50 10,996.64 12,803.05 13,409.28 16,847.26 18,305.27 19,166.75
Premium excluding GST
51-55 14,883.06 15,739.62 16,562.64 23,806.07 24,480.26 25,023.80

PREMIUM TABLE (Excluding

56-60 GST)21,273.36
20,995.28 21,926.25 33,865.95 35,796.97 36,884.65

Premium Coverages Sum Insured = 25 Lakhs

Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K
0-25 8,862.02 10,648.93 12,228.68 12,089.40 14,955.05 18,453.48
Sum Insured
Sum Insured ==5 5 Lakhs
Lakhs Sum Insured = 10
LakhsLakhs
Sum Insured = 10
Age / SI Individual 1A+1K 1A+2K
26-30 2A9,792.94 2A+1K 2A+2K
11,066.91 Age / SI
12,723.26 Individual 13,188.651A+1K 1A+2K
15,420.76 2A 19,286.54 2A+1K 2A+2K
0-25










 










 








 








  








 








  0-25





































 








 








  
26-30





















 

















 








 








 26-30




























 








 

















  
31-35





















 








31-35
  9,791.68









 








   11,065.66









 12,722.00
31-35










 13,186.13









 15,418.24









 








19,284.03
 

















 
36-40










 

















 








 








 








 36-40



































  








 









41-45










 


















36-40








 








  12,886.28
11,409.59








 14,163.77
41-45








 16,132.22









  17,988.18


















19,992.56









 









46-50








 












































  46-50








 








 








 

















 








 
51-55








 








  








 








  








 








  51-55








  

















 








 

















 
56-60








 








 








41-45
 








 11,467.35









  12,944.05









 14,221.54
56-60








 
16,247.75









 
18,103.70









 
20,108.09


















 








 
61-65

















 


























 








  61-65








  








  








  


























 
66-70








 








 46-50









 








14,925.82
 








 17,300.88









  18,071.61
66-70








 22,469.11









   24,387.78









 








25,524.99




















51-55 20,006.93 21,137.69 22,192.42 31,564.95 32,456.82 33,177.54

56-60 28,037.35 29,065.67 30,236.48 44,790.23 47,328.54 50,561.25

Sum Sum
Insured
Insured = =
25 25
LakhsLakhs Sum Insured = 50 Lakhs
Sum Insured = 50
LakhsLakhs
Sum Insured = 50
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K
0-25








 








 Age









 / 
SI Individual









 








   1A+1K









 1A+2K
0-25








  2A








   2A+1K










  








2A+2K









  








 
26-30

















 








 








 








 








  26-30

















  








 

















 








 
31-35








 

















0-25
  10,318.90


















 12,529.68









  14,477.94
31-35 14,230.22


















  17,807.94










  22,187.51



























 
36-40

















  








 

















 








 36-40








  

















 

















 








 
41-45








 








  








  

















  13,059.13









  41-45








 








 

















 

















 
26-30 11,498.33 15,104.45 15,622.75 18,397.66 23,242.73
46-50


























 








 

















  46-50

















 








  








 


















51-55








  








 


























 








  51-55

















 








  


























 
56-60








  








  31-35









  11,497.08 13,057.87









 








 








  15,103.20
56-60 15,620.23









  18,395.15









 








 23,240.21









 

















 
61-65








 








 



































 61-65








 























 





 





 
66-70








 








 36-40















 13,541.72






 15,359.39






 66-70
16,924.64

















 
19,342.38








 
21,640.64





24,126.99
 













Premium excluding GST

41-45 13,599.48 15,417.16 16,982.40 19,457.90 21,756.17 24,242.51

46-50 17,947.86 20,903.93 21,827.02 27,273.25 29,650.99 31,038.47

51-55 24,354.98 25,734.30 27,017.26 38,736.19 39,812.79 40,672.51

56-60 34,481.72 35,731.22 37,161.28 55,396.50 58,559.44 62,602.29

 PREMIUM TABLE (Excluding GST)
Advanced Coverages
Sum Sum
Insured = 5 Lakhs
Insured = 5 Lakhs
Sum Insured
Sum Insured ==
1010 Lakhs
Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K
0-25










 



















 








  








 








   0-25




























 








 








 








  
26-30










 










 








 


























  26-30










 


























 








 









31-35





















 

















 

















 31-35










 








 








 








 








 








 
36-40



















 








 








 

















 36-40








 

















 








 

















 
41-45



















 

















 

















  41-45








 

















  



























46-50

















  








  

















 








  46-50








 








 

















  








  









51-55








  

















 








 

















  51-55


























 

















 








  
56-60

















 








 

















  








  56-60

















 








 

















 








 
61-65








 








 








  








 








 








 61-65


























 








 








 








 
66-70








 








 








 


























 66-70

















 

















 





 





 

Sum Insured
Sum Insured ==
2525
LakhsLakhs
Sum Insured
Sum Insured ==
5050
LakhsLakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K
0-25








 








 








  








  

















  0-25








 








  








 


























 
26-30








 








  








  








  








 








  26-30








 








 

















  








 








 
31-35

















  








 








 








 








  31-35








  








  


























  








 
36-40








  








 

















 








 








 36-40








 

















 








 








  









41-45








  








  








 








  

















  41-45








  

















 

















  








 
46-50

















 








 

















 








  46-50








  








 

















 








 









51-55








  








 








 








 








 








 51-55








 








  








 








  








 








 
56-60








 

















 


























  56-60








 








 








  

















 








 
61-65








 








 








 








 





 





  61-65


























 





  





  






66-70








 








 








 





 





  





 66-70








 














 





  





 





  

Premium excluding GST

PREMIUM TABLE (Excluding GST)

Worldwide Coverages

Sum Insured =5050

Sum Insured = Lakhs
Lakhs Sum Sum
Insured
Insured == 100
100 LakhsLakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K
0-25








 








 








 

















 








 0-25

















 








  








 








  









26-30








 








 

















 

















  26-30








 








 

















  








 









31-35








 








 

















 








 








   31-35








 








 








 








 


















36-40








 


























 








 








 36-40








 

















  

















 








 
41-45








  








 








 


























  41-45


























  



























46-50








 

















 








 








 





  46-50


























 





 











  
51-55








 





 





  





 





 





  51-55





 





 











  





  





 
56-60





  





 





 





  





  





  56-60





  





 





 





 





 





  
61-65





  





  





 





 





 





  61-65











 





  





  





  





 
66-70





 





  





 





  





 





   66-70





  





 





 





 





 





  

Premium excluding GST

*Optional Covers are available on the selected options under this Policy on payment of addtional premium. The add-ons are applicable only within the geographical boundaries of India.

**Reset will not trigger for the first claim. Reset will not trigger for same person with same illness for which a claim has been paid in that policy year.

#Worldwide cover benefit is available for 45 consecutive days from the date of travel in a single trip and 90 days in a cumulative basis as a whole in a Policy year. A co-pay of 10% will be applied to every admissible claim over and above to any
other co-pay levied.

## Increase of 10% of annual sum insured immediately preceding each policy year subject to a maximum of 100% provided there is no Claim during the Policy Year. And In case of claim made the accrued Additional Sum insured will get reduced
in the same proportion in which it has been accrued.

1) Prohibition of Rebates – Section 41 of the Insurance Act, 1938 (1) No person shall allow or offer to allow either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk
relating to lives or property in India any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such
rebate as may be allowed in accordance with the published prospectus or tables of the insurer.

2) If any person shall fail to comply with sub regulation (1) above, he shall be liable to payment of fine which may extend to rupees ten lakhs.

Only for the customers of HSBC Bank Limited who wish to avail Health Shield 360 Insurance. Master Policy No. (4177i/MSTR/247427045/00/000) underwritten by ICICI Lombard GIC. The advertisement contains only an indication of cover offered.
For more details on risk factors, terms, conditions and exclusions, please read the sales brochure /policy wordings carefully before concluding a sale. HSBC Bank having registered address at 52/60, 2nd Floor, HSBC Building, M G Road, Flora
Fountain, Fort, Mumbai, 400001 is registered as a Corporate Agent (CA0016) of ICICI Lombard General Insurance Company Limited. ICICI trade logo displayed above belongs to ICICI Bank and is used by ICICI Lombard GIC Ltd. under license
and Lombard logo belongs to ICICI Lombard GIC Ltd. ICICI Lombard General Insurance Company Limited, ICICI Lombard House, 414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025. IRDA Reg. No.115 Toll Free 18002666, Fax No 022
61961323 CIN L67200MH2000PLC129408. Website: www.icicilombard.com Email: [email protected]. Product Name: Health Shield 360 UIN: ICIHLGP22083V022122. ADV/15348.
 HEALTH SHIELD 360 - WORLDWIDE COVER
The worldwide cover offers a higher Sum Insured with a worldwide hospitalisation cover for
emergency and planned hospitalisation requirements.

Worldwide cashless facility at network centers*

Daycare procedures
HEALTH SHIELD 360 -
WORLDWIDE COVER

International emergency medical services

(Air & Roadside ambulance)

Note : Worldwide cover benefit is available only when Insured member (Indian resident) is travelling abroad and his single trip is not more than 45 days
and multiple trips taken abroad by customer in a policy year is not more than 90 days. The scope of this cover extends to worldwide including India, USA
and Canada and the Maximum limit of indemnity would be restricted to the Annual Sum insured for claims within and outside India, in aggregate. A co-pay
of 10% will be applied to every admissible claim, if the treatment is taken outside India.
*as per availability.
 TERMS & CONDITIONS

Eligibility
• Adults from 21 to 70 years of age, Children from 91 days to 20 years of age; child
will be covered under floater plan only

Tenure
1 Year
TERMS & CONDITIONS

Family definition
Self, Spouse and up to 2 dependant children upto 20 yrs. of Age.

Room rent restriction

Nil

Waiting Period
• Initial Waiting Period: 30 days for all illnesses (except hospitalisation due to
injury).
• Expense related to hypertension, diabetes, and cardiac conditions within 90 days
from the policy commencement date unless they are PED.
• Pre-existing diseases: 24 months waiting period for declared and accepted PEDs.
• Specific disease waiting period: 2 years, for specific Illness and treatment. (Please
refer to the policy clauses for the full listing).

Conditional Underwriting
• When an insured member declares an existing illness, a medical underwriting is
done for such proposal. On the basis of the medical underwriting the proposal is
either accepted with loading on premium or its rejected
• Customer is enrolled in the policy with loading on premium and also becomes part of
Be-Healthy program of 360 Wellbeing Program
MAJOR PERMANENT EXCLUSIONS
(This is an indicative list of exclusions. For complete details please
refer the policy wordings)
• Medical expenses incurred during the first 30 days of inception of the policy,
except those arising out of accidents. This exclusion doesn’t apply for
subsequent renewals without a break
• Expenses attributable to self-inflicted injury (resulting from suicide, attempted
suicide)
• Expenses arising out of or attributable to alcohol or drug use/ misuse/ abuse
• Cost of spectacles/ contact lenses, dental treatment
IL TAKECARE
A one stop solution for your insurance and wellness needs. Download the IL TakeCare app to avail
the following services and much more as per your policy, all at the ease of your fingertips.

• Convenient & Easy-To-Use app

• Wide range of Emergency & Convenient Medical solutions at your fingertips as per the policy terms

• Quick Claim Process

• Wellness Programs to help keep you fit

DIGITAL POLICY

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CONSULTATION CLAIMS

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 CLAIM PROCESS
HOW TO INTIMATE A CLAIM?
Reach us at:

18002666
Monday to Saturday between 8:00 am to 8:00 pm

[email protected]

IL TakeCare app

CASHLESS CLAIMS
CLAIM PROCESS

• Get admitted in any one of our network hospitals

• Reach out to insurance desk in hospital and submit the pre-authorisation
claim form along with relevant documents
• Hospital insurance desk shares the pre-authorization documents with IL
Health Care
• ICICI Lombard Health Care reviews your claim requested and accordingly
will approve, query, or reject the same (as per policy terms and conditions)

REIMBURSEMENT CLAIMS
If hospitalisation occurs in a non-network hospital:
• Upon discharge, pay all hospital bills and collect all original documents of
treatments and expenses underdone
• Send the duly filled (and signed by insured and treating doctor) claim form
and required claim documents
• ICICI Lombard Health Care will review your requested claim and will
accordingly approve, query, or reject the same (as per policy terms and
conditions)
• ICICI Lombard Health Care Settles the claim (as per policy terms and
conditions) and reimburses the approved amount

Below are the places from where you can download the claim form.

IL TakeCare App

ICICI Lombard Website

ICICI Lombard customer support helpline – 18002666

 HEALTH INSURANCE FAQ
1. Why do I need Health Insurance?
Healthcare is expensive. Technological advances, new procedures and
more effective medicines have driven up the cost of healthcare. This
FREQUENTLY ASKED QUESTIONS.

increase has to be borne by the consumer, making treatment

unaffordable for too many. Health Insurance overcomes these obstacles
so that you remain free of anxiety regarding your health. Think for a
moment about the enormous medical costs you would incur if you
suffered a major accident tomorrow or were suddenly stricken by an
illness. Uninsured people live with such risks every day. Health insurance
seeks to shield you from that risk. It provides the much needed financial
relief. You also get tax benefit under section 80D of the Income Tax Act
and amendments made thereto.
2. How will health insurance pay for my emergency medical expenses?
Your health insurance will either pay your hospital bills directly if opted for
the cashless facility or it will reimburse any payment made by you towards
medical expenses incurred due to an illness or injury as per the policy
terms.
3. What do you mean by Family Floater Policy?
Family Floater is one single policy that takes care of the hospitalisation
expenses of your entire family. The policy has one single sum insured,
which can be utilized by any/ all insured persons in any proportion or
amount subject to maximum of overall limit of the policy sum insured, as
per policy terms and conditions.
4. Will my health insurance cover begin from day one?
When you get a new policy, there will be a 30 days waiting period starting
from the policy inception date, during which period any hospitalisation
charges will not be payable by the insurance companies. However, this is
not applicable to any emergency hospitalisation occurring due to an
accident. This waiting period will not be applicable for subsequent
policies under renewal. Furthermore, in case of a declared pre-existing
disease, a waiting period of 24 months will be applicable and certain
specified diseases shall have a waiting period of 24 months.
5. What is pre-existing condition in health insurance policy?
It is a medical condition/ disease that existed before you obtained health
insurance policy
6. If my policy is not renewed in time before expiry date, will it be denied for
renewal?
The policy will be renewable provided you pay the premium within 30
days (called as Grace Period) of expiry date. However, coverage would
not be available for the period for which no premium is received by Us.
The policy will lapse if the premium is not paid within the grace period.
7. What happens to the policy coverage after a claim is filed?
After a claim is filed and settled, the Policy Sum Insured is reduced by the
amount that has been paid out on settlement.
For Example: In January you start a policy with a coverage of `5 Lakh for
the year. In April, you make a claim of `2 Lakh. The coverage available
to you for the May to December will be the balance of `3 Lakh.
 8. What is Unlimited Reset Benefit?
It is a benefit that allows an insured to reinstate the entire sum insured in
the policy year when it is insufficient as a result of previous claims in that
FREQUENTLY ASKED QUESTIONS.

policy year. In case the entire cover is exhausted, it gets replenished

automatically for the next hospitalisation that occurs within the policy
year. Reset will not trigger on first claim and cannot be used by same
person for same illness for which the claim has already been paid in the
policy.
9. Does my policy offer worldwide cover?
On the basis of the plan selected, Health Shield 360 Insurance policy
covers Hospitalisation expenses (including planned hospitalisation)
incurred abroad as well.
10. Can I increase my Sum Insured at the time of renewal?
Yes, you can increase the Sum Insured at the time of renewal. However,
fresh waiting period would apply for the enhanced Sum Insured.
 HEALTH SHIELD 360 HEALTH SHIELD 360

HEALTH SHIELD 360

HEALTH SHIELD 360
HEALTH SHIELD 360
HEALTH SHIELD 360 HEALTH SHIELD 360
HEALTH SHIELD 360 HEALTH SHIELD 360
HEALTH SHIELD 360 HEALTH SHIELD 360

*Optional Covers are available on the selected options under this Policy on payment of addtional premium.
**Reset will not trigger for the first claim. Reset will not trigger for same person with same illness for which a claim has been
paid in that policy year.
#Worldwide cover benefit is available for 45 consecutive days from the date of travel in a single trip and 90 days in a
cumulative basis as a whole in a Policy year. A co-pay of 10% will be applied to every admissible claim over and above to any
other co-pay levied.
## Increase of 10% of annual sum insured immediately preceding each policy year subject to a maximum of 100% provided
there is no Claim during the Policy Year. And In case of claim made the accrued Additional Sum insured will get reduced in the
same proportion in which it has been accrued.
Prohibition of Rebates – Section 41 of the Insurance Act, 1938 1) No person shall allow or offer to allow either directly or
indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating
to lives or property in India any rebate of the whole or part of the commission payable or any rebate of the premium shown on
the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be
allowed in accordance with the published prospectus or tables of the insurer. 2) If any person shall fail to comply with sub
regulation (1) above, he shall be liable to payment of fine which may extend to rupees ten lakhs. Only for the customers of HSBC
Bank Limited who wish to avail Health Shield 360 Insurance. Master Policy No. (4177i/MSTR/247427045/00/000) underwritten
by ICICI Lombard GIC Ltd The advertisement contains only an indication of cover offered. For more details on risk factors,
terms, conditions and exclusions, please read the sales brochure /policy wordings carefully before concluding a sale. ICICI
trade logo displayed above belongs to ICICI Bank and is used by ICICI Lombard GIC Ltd. under license and Lombard logo
014375LF

belongs to ICICI Lombard GIC Ltd. ICICI Lombard General Insurance Company Limited, ICICI Lombard House, 414, Veer
Savarkar Marg, Prabhadevi, Mumbai – 400025. IRDA Reg. No.115 Toll Free 18002666, Fax No 02261961323 CIN
L67200MH2000PLC129408. Website: www.icicilombard.com
Email: [email protected]. Product Name: Health Shield 360 UIN: ICIHLGP22083V022122. ADV/16420
022724SD-SHT