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Health Insurance

What is the eligibility/age limit applicable for ICICI Pru Heart/Cancer Protect?

The policy can be renewed up to the age of 75. ICICI Pru Heart/Cancer Protect can be bought when you are between 18 and 65 years of age. The minimum policy term you can opt for is 5 years, which comes with lower premiums if you choose the Single Pay option. In case you choose Regular Pay, you can determine your policy term to last from 5 to 40 years.

What do you mean by waiting period?

a. The benefit shall not apply or be payable in respect of any listed conditions of which the symptoms have occurred or for which care, treatment, or advice was recommended by or received from a physician, or which first manifested itself or was contracted during the first six months from the risk commencement date or three months from the policy revival date where the policy has lapsed for more than three months.

b. In the event of occurrence of any of the scenarios mentioned above, where it is established that the Life Assured was diagnosed to have any one of the listed conditions during the waiting period for which a claim could have been made, the company will refund the premiums from risk commencement date of the policy or from the date of revival as applicable and the policy will be terminated with immediate effect. For policies with family benefit, this Life Assured will be removed and the policy will continue for the other Life Assured with the reduced premium from the next premium due date.

c. If cancer cover and heart cover are taken together, premiums corresponding to the cover and its additional benefits (if any), under which the claim is made will be refunded from risk commencement date of the policy or from the date of revival as applicable for that Life Assured. The cover and its additional benefits for which the premiums have been refunded will cease with immediate effect. The policy will continue with the other cover and its additional benefits (if any), and all future premiums will be payable only for this cover and its additional benefits.

d. No waiting period applies if any of the listed conditions occur due to accident.

What is Family Benefit offered under this policy?

You can avail a discount of 5% on first year’s premium, on purchasing this product for you and your spouse. This discount will not be applicable from the second year.

Can I avail the family benefit later during the policy term?

Family benefit will have to be chosen at the inception of the policy only. Spouse cannot be added once the policy is issued. The policy benefits of both the Life’s Assured shall be independent of each other.

This discount is not applicable on single pay policy.

Will my premium increase over the policy term?

Response: The premiums are guaranteed for a block of three (3) years after which it can be revised with prior approval of IRDAI. Premiums, if and when revised, will be guaranteed for a subsequent block of three (3) years. We will inform you about the premium revision, if any, at least 3 months in advance.

The revision in premiums, shall not be based on any individual policy claim experience.

For single Pay policies, the premium is guaranteed for the entire policy term.

What is increasing cover benefit?

Your sum assured will increase by 10% simple interest every year, till the time first claim is made. The maximum sum assured under increasing cover benefit is limited to 200% of the sum assured chosen at inception.

What is the grace period for renewal premium payment?

A grace period for payment of premium of 15 days applies for monthly premium payment mode and 30 days for other modes of premium payment. If the premium is not paid within the grace period, the policy shall lapse and cover will cease. This is applicable for Regular Pay only.

What is offered under hospitalisation benefit?

You will get daily hospital cash benefit of Rs. 5,000 if you get hospitalised for a continuous stay of 24 hours, due to any of the listed conditions under your chosen cover. The benefit amount is fixed and will be paid irrespective of actual hospitalisation expenses. This benefit will be payable subject to a maximum limit of ten (10) days per policy year and thirty (30) days over the policy term. The yearly limit of number of days of hospitalisation cannot be carried forward to next year.

Will Ayurvedic treatments be covered?

Ayurvedic, Homeopathy, Unani, Yoga and Naturopathy, Siddha, Reflexology, Acupuncture, Bone-Setting, Herbalist treatment, Hypnotism, Rolfing, Massage Therapy, Aroma Therapy or any other treatments other than Allopathy / western medicines are excluded under this hospital benefit.

What is the minimum sum assured I can take under this policy?

The minimum sum assured that you can avail is Rs. 2 lakh for cancer and Rs. 2 lakh for heart.

How does income benefit work?

1% of the sum assured chosen at inception, will be paid to you each month for a period of 5 years on diagnosis of any of the major conditions under the cover. This benefit is over and above the lump sum payable.

Are pre-existing diseases covered?

Pre-Existing diseases are not covered. Pre-Existing disease means any heart or cancer condition (primary or metastatic); pre-cancerous condition or related condition(s) for which the insured had signs or symptoms, and/or was diagnosed, and/or for which medical advice / treatment was received within 48 months prior to the first policy issued by the insurer and renewed continuously thereafter.

Any investigation or treatment for any illness, disorder, complication or ailment arising out of or connected with the pre-existing illness shall be considered part of that pre-existing illness.

No benefits will be payable for any condition(s) which is a direct or indirect result of any pre-existing conditions unless Life Assured has disclosed the same at the time of proposal or date of revival whichever is later and the company has accepted the same.