ICICI Lombard Group Health Insurance
ICICI Lombard’s Group Health Insurance (ICICI Lombard GHI) is amongst the leading healthcare schemes offered by ICICI Lombard General Insurance (ICICI Lombard). ICICI Lombard provides a comprehensive group health insurance policy to small, medium, and large organizations.
In addition, they also offer a wide range of employee health benefits consisting of group personal accident insurance, doctor consultations, health checkups, and more.
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Key statistics of ICICI Lombard general insurance company*
GHI Premiums
GHI lives insured
Health lives insured
Health claims Processed
Health claims settlement ratio***
Health claims Settled within 3 months
Awards and recognitions
Excellence in Financial Reporting
Excellence in Financial Reporting
Excellence in Financial Reporting
Excellence in Financial Reporting
Excellence in Financial Reporting
Excellence in Financial Reporting
What is group health insurance?
Group Health Insurance (GHI) is a type of insurance scheme that covers employees and workers of a company. As an employer, it is your responsibility to implement a group coverage policy within the organization. With a group medical plan, employees and their family members can avail superior health care benefits and medical treatment, including accidental and emergency-related incidents. ICICI Lombard has excellent group insurance offerings for companies of all sizes.
Highlights of Group Care Insurance
Dedicated health assistance services
Complete cover for your employees and their families
Extensive network of 6536 hospitals and 273 branches across India
Unlimited general physician consultations
840 virtual offices
Customised plans for small, medium enterprises and large organisations
Standard benefits offered by ICICI Lombard group health insurance
Feature
Type of Cover
Eligibility criteria (Age)
90 days - 80 years
Option to provide cover to the baby from Day 1
Who/What is included?
Employee as well as their spouse, children, and parents
Inpatient hospitalization and accidental emergency
Illness/injury during the policy period
Waiting period
Waived off
Attendant cover
Yes, covered up to ₹5,000 per family within Sum Insured if the length of stay for the patient is more than five days on a reimbursement basis. This covers costs pertaining to boarding and lodging of the attendant in a hospital/location.
Sum Insured
Ranges from ₹50,000 to ₹10 lakhs
Hospitalisation cover
60 days and 90 days, respectively
Room rent and ICU
Ability to have uncapped room rent and ICU expenses
Eye treatment
Lasik surgery is covered if the correction index is +/- 6.5 DCataract surgery is covered
Pre-existing cover
Option to cover all pre-existing diseases expenses from Day 1
Day care treatments
Included
Mental health
Yes, hospitalisation due to psychiatric conditions for upto ₹30,000
General list of exclusions
Infertility and sterility
Septoplasty
Admin and miscellaneous related charges
Holter monitoring
Prosthesis
Experimental treatment
Additional benefits offered by ICICI Lombard group health insurance
Ambulance Cover
Covered of up to ₹5,000 per hospitalization Air Ambulance - Covered up to ₹1,00,000 or family sum insured, whichever is less
Home Healthcare
Covered only on a cashless basis, the service is presently available in nine cities across India (Bangalore, Chandigarh, Chennai, Delhi (NCR), Hyderabad, Jaipur, Kolkata, Mumbai, and Pune)
Health Assist Services
Available on-call for queries regarding:
1. Specialist
2. Hospital
3. Fixing an appointment with Doctors or Nutritionist
4. Facilitating 2nd opinion and more
Specific Condition
Terrorism
Lucentis up to ₹50,000 per family within SI
Internal congenital diseases, only if it is life-threatening
AYUSH Treatment
Covered only in a recognized government hospital along with a valid medical practioner’s prescription
Add-on benefits offered by ICICI Lombard group health insurance
General
Outpatient department (OPD Cover - Reimbursement)
Health check-ups
Maternity
Option to have maternity benefit for C-section and Normal Delivery (up to ₹75,000) for up to two babies
Pre-and-post natal expenses of up to ₹5,000 covered within the Maternity limit
Newborn baby cover
Please note that Plum has collated and presented this data for informational purposes only and at a particular point in time. Plum does not endorse, rate, or recommend any particular insurer or insurance product offered by an insurer. The final terms, conditions, and premiums may vary depending upon factors including group size, age, location, and applicable taxes.
Here's how ICICI Lombard is better with Plum
Complete digital experience
Cashless process enables the insured to get treated at any network hospital without any upfront payment. This helps your employees get treated for ailments without any financial burden.
Cover for businesses of all sizes
Get the best online group health insurance for teams and companies of all sizes.
Scales as you expand your team
Add or remove employees and medical benefits as you scale.
Doctor on call
Get teleconsultations from our expert doctors along with advice on medical and general health.
Plum Wellness
Get access to corporate wellness programmes for your employees.
Insurance on WhatsApp
Start a claim, download your eHealth card, check policy details, and much more on WhatsApp.
Single Dashboard
Be it employer or employee, desktop or mobile, check your insurance plan & health benefits dashboard anywhere.
Track your claims
Know how your team is utilizing their employee benefits and medical coverage.
Documents required for claims process
This can be understood better by the type of claims process you have opted for - Cashless or Reimbursement.
Duly filled and signed claim application form (with employee code)
Original hospital bills with a break-up of expenses
Discharge summary and payment receipts
Invoice and sticker for implants
Medical practitioner’s prescription
Pre and post hospitalization bills for medicine and consultation
In case of an emergency, get yourself admitted to the nearest network hospital
Your health card - you need to show this at the TPA desk in the hospital
Confirm your treatment plan with the doctor/hospital
Discharge certificate and medical bills/invoice
Claims application form
Frequently Asked Questions
Can I add or remove members after the initial setup?
Super top-up is additional coverage of 20 lakhs added to your existing policy. You can avail the additional cover for yourself, and/or for your entire family (self+spouse+2 kids), and/or your parents.
This policy, however, comes with waiting periods on certain critical illnesses and applicable deductibles.
How are premiums calculated for additions?
Yes, you can add new employees, add new dependents (at the time of marriage or childbirth), and remove employees who exit the company. Additions and deletions can be done using the Plum dashboard.
Do I get refunded for deletions?
Deductible refers to the amount paid by the policyholder (via out-of-pocket or other medical insurance policy) before the super top-up kicks in. Read all about how a deductible works here.
How do I pay for additions and deletions?
No, the policy doesn’t cover same-sex or unmarried couples.
Can an employee convert the group plan to an individual plan if they leave the company?
No, the policy doesn’t cover same-sex or unmarried couples.