How does my plan work?
You can choose from any of the following four plan types. Each plan type offers the benefits amounts, as shown below:
Benefit amounts at-a-glance
| Benefit |
Plan A (Rs.) |
Plan B (Rs.) |
Plan C (Rs.) |
Plan D (Rs.) |
| DHCB (per day) |
1,000 |
2,000 |
3,000 |
4,000 |
| ICUB (per day) |
1,000 |
2,000 |
3,000 |
4,000 |
| Surgical benefit |
|
|
|
|
| Grade 1 |
10,000 |
20,000 |
30,000 |
40,000 |
| Grade 2 |
20,000 |
40,000 |
60,000 |
80,000 |
| Grade 3 |
30,000 |
60,000 |
90,000 |
1,20,000 |
| Grade 4 |
40,000 |
80,000 |
1,20,000 |
1,60,000 |
| Grade 5 |
75,000 |
1,50,000 |
2,25,000 |
3,00,000 |
| Grade 6 |
1,00,000 |
2,00,000 |
3,00,000 |
4,00,000 |
| Grade 7 |
1,50,000 |
3,00,000 |
4,50,000 |
6,00,000 |
| Non-surgical benefit (per day) |
1000 |
2000 |
3000 |
4000 |
| Recuperating benefit |
3000 |
6000 |
9000 |
12000 |
| Prolonged stay benefit (per day) |
1000 |
2000 |
3000 |
4000 |
| Health check-up |
Up to 4,000 |
Up to 4,000 |
Up to 4,000 |
Up to 4,000 |
Policy benefit limits
| Benefit |
Plan A (Rs.) |
Plan B (Rs.) |
Plan C (Rs.) |
Plan D (Rs.) |
| Annual limit |
4,00,000 |
8,00,000 |
12,00,000 |
16,00,000 |
| Lifetime limit |
20,00,000 |
40,00,000 |
60,00,000 |
80,00,000 |
There is an initial waiting period of one month from the policy commencement date. (Except for hospitalisation due to an accident)
How do I claim under the plan?
Take advantage of cashless hospitalisation through our extensive list of network hospitals available across the country.
You can also claim your benefit amount for treatment in any out of network hospital through our hassle free claims process.
4 easy steps to process a claim:
| Hospitalisation in network hospital |
Hospitalisation in out of network hospital |
- Show Health Card and fill the pre-authorisation form
- Hospital will submit the pre-authorisation form and we will verify the claim request
- Cashless hospitalisation will be authorised
- ICICI Prudential pays amount to the hospital
|
- Settle your hospital bills
- Submit claim documents post discharge
- We will verify your claims
- A cheque will be sent to your address
|
Photocopies of hospital bills, discharge card, doctor's certificate, prescriptions, diagnostic reports and any other relevant documents will be needed to process your claim.
To know more on our in-house claims process or for a detailed list of the network hospitals call us on 1800-103-6363 (24 x 7 toll free number)
What are the major exclusions?
- Pregnancy, infertility, congenital external diseases or anomalies / genetic conditions
- Non-allopathic medicine,
- Domiciliary treatment,
- Circumcision, sex change surgery, cosmetic surgery & plastic surgery
- Organ donor expenses
- Any treatment for substance abuse, self-inflicted injuries, STDs and AIDS
- Hazardous hobbies or avocations, war, terrorism, civil war or breach of law
(Note: The above is a partial listing of exclusions. For complete details, please read policy terms & conditions.)
Download & FAQs
You can download the following:
- Brochure
View and print ICICI Pru Hospital Care II brochure for your convenience. Download here.
- Pre-authorisation form
Use this form to apply for pre-authorisation in order to avail of the cashless facilty at a network hospital.Download here.
- Network hospital list
Complete list of hospitals covered under our network. Download here.
- Policy wordings
Understand your policy terms & conditions better by reading the policy wordings carefully. Download here.
- FAQs
Click here to check FAQs on ICICI Pru Hospital Care II.
