At ICICI Lombard, we believe that health Insu1ance is not just ii matter of saving tax or getting the

pioteet1on you need. It Ciln be so much m0fe. It's about partnering wi th you to find precisely what W0fk5
for you based on yoi. needs and then going the extra m~e to deli ver more than what we promise.

Upgrade your protection with additional" covers

@) World Wide
Cover
ASI
Protector

Claim Sum Insured

© Protector Protector

i13 Super No
Claim Bonus
Air Ambulance
Cover

@ Emergency
Services
rP Donor
Expenses

0 &
Unlimited Domiciliary
Reset Benefit Hospitalisation

•n,.., ... ~.,,..,o,:cep1M~S..-.---- .. ....-l>rP'Plll "'tttp-tnlUft.

IC!att°""logo~..,..-.tolCICIBanlond11-t.r1CO~GICUd. ...... k..,..ondl«rmnllogo-.,tolCl'.:ll.omt>anlGICUd.
Tho _ _ _ o_,~.,_.,..,ollht<--For""""'""'-°" ' "" !octor1, t111?a,--.-19Mondn-.plotot
rudll'lt~cloclontnlo•ll'l.t:ybolln<Otd.ding1Ult.lXll.oonlllrdc...i-.,,..~1,m1od. Rog,ot-Olil<o:ICICILOfl"ladfli>J•, 414,
V..S.,•l•""-Q.r.t•Si<l<ln'nl\"II.Ton,pio,l'llttlldhi.t.\ariHii•40002!;.IROA!lt9-No.l\S.ICIC l lomlllr<ic.orr.,IKtlloollh..,,.,onct. UUt
IC lfllP?138JV05Z021.Ml1<l26. ToilFrNNo. l e00 26o6.!=a,No022'619613Zl.CtllJ1200MH200Cf\C129'40!. Websmr:www.---.!.oom. t moil
eus1,,....,uppor1@~dorm,,o.tom AtN/IOl(J
 AtlCICILombard.webelievethathealth1nsuranceisnotjustamatterofsavingtaxorgett1r,g1he
protection you need. It Cil'l be so much mer,. It's about partnering with you to find precisely what works
for you based on your needs and thefl go ing Ille extra mile to de liver mDfe than what we promise.
Upgrade your protection with additional" covers
WorldWideCover:
@:7 In case !ht custome r has opted tor this covtr, Hospitalizahonexpensts incurrtd1broltdstlall be paidwilha
co-payoflO,,.Thisbenel1t1savailablelorSl.WTllnsuredorl0Lilcsandabove.

Claim Protector:
lncaset1i,custorntr h1soptedforthisc0Ytr,the lRDAllistof non~y1 bleitemsshall becomep1V•hl•in
ElP cas, ofecllim.
Super No Claim Bonus:
In cast the customtr has opted for ttus cover, thert will be I SO'A, bonus awarded for every claim ffH year
subj&ctto1max1murnof100,,forSIDplionsupto 10Landi,.ito20111ilorSloptions 15LandaboVI!

EmergancySarvicas:
i. 0o1Tlf31ic Road Ambulance -ExpenH5 incurred on roitd am bu lane, services wil l bt covered. Covtrage
limrt underltiis shall b1 l'!lio olthe S/upto a maximum of~l0,000
ii. Ambulanceassistanct
iii.Vrrtualconsult!ltionviaTelt•consultll1on/Video/onlinep011al

0 UnlimitedResetBenefit:
'\._..,, ~•WII rest! 14110 lao"ofthe bM1 Sum !nsured unlimited bmn ma p~icy yearm case the Sum lnsurtd
1nclud11_g accrued adcftioMBI Si.m Ins ured (if any), S14>ff No Claim Bonus (if 1111yl Sid Sum lnSIStd protector
ld 1ny) 1s ins ufficient IS e result of pnMous claims m that p~rcy year.

§ASIProtector:
ASI 1ccrutd by the custom t r sJ\al 1'(11 be impacted~ 1ny one claim or multiple cltims admiSliblt in tha
previousytardonnotexcaedthaovtrallamountof~50,000. Thi$benefit isavaitblelorSumlnsurtdof5
lacsandabovt

SurnlnsuredProtecto,:
L§ In ttse ltiecustomtrhas optedlorthiscover. the Slwinbe increued 11 renewal on the basis cl inflation
11teolpreviousyear.

~:!~~~~•:c:,cb:::r~um Insured for Aft_ Ambulanct tl(j)tnies incurred to transfer th• lnsurtd Person
lolowrngan em, rgencytothenea rutKosprtal.

fiP OonorExpenses:
Medical Expenses incurred in respe,ct of the donor lot any of the Ofga,l transplMll surgery prov ided the
organd0r11ttdis!0rtheinsuredperson'suse. '

--
'f£t ~v~!~~I~';!.:':.i1t!!~~~:s"i~ a
"'"-'--..
....... ...
stall

:n~~:;:~:==~:;;;=::re---=e:.:::::~:=
lituetion whtr1 lh1 lnsurtd Person is in such_a

..-........... ,,__
that hi/she camot
bemovedtoa hosp1talorthelreabnent1stakenatrlllme 1fthere'1anon.avt11 labilrtyofroominlhehospilal
Introducing 4 new plans under our ICICI Lombard Complete Health Insurance Health Shield, Health Shield
Plus, HealthEliteand Health Ehle Plus, whichofferahostofbenelitstocatertoallyourhealthcareneeds.

UPGRADE YOUR PROTECTION WITH ADDITIONAL"COVERS

Health Shield Non OPD Plan

Health Shield Plus Non OPD + World Wide Cover
Health Elite OPD + Maternity Plan
Health Elite Plus OPD + Maternity + World Wide Cover

10 NEW ADD ON COVERS

0 Unlimited Reset Super No Claim Bonus

6P Donor Expenses
© Claim Protector

Domiciliary Hospitalisation ASI Protector

Air Ambulance Sum Insured Protector

® Emerg ency Assistance World Wide Cover

·n-.. odd-on..,....ucep11orEmtr~S-. ~1111v1rllblebypeyngem~ -

ICICllr.OOloVo ..splayad- ....... tolCICl6ri.ind <1 useolbylCICll.ombardGIClld . ......,llcanMindl.ambadlo90.......,.tolCICILombanlGICLld
Tht~-od,/1nidcauonollhl<0",'81ol!ored.f<lfcoq,lffldfflillonrilillct«s.tema.~ca,er"'J'O'lind~~rttd
lhlpaky.......-~tlUil!'be!oll«ineludlnQ1s.all.lCICll.ombardc-alinwr-COff"9111'1Lmiled.AtQISlffldotllce:ICICll.ambadllouso.414, V..
SIYIB.ll"Mll-9-Nu-Soclihw,ayllll........ Prllbh.otYi.~ • 400025. IADAlla,g.No. 115.lCICIL.omba<d~ ........ lrlslatnet. lJN:
ICIHUP21383VO!i2021. Msc 128. Tai Fr• No. 1800 26&6. No on61M132l. CIN L672IXMH2000PI.C129408. Wobme: www.iaalonmord.QOIII. &nllit
CIIStOnWSU~Ollffl AfN/10149.
 '\._; . •==
®l~'iW~I/H.fflijf RHil
:f: ® HEALTH ELITE · PREMIUM CHART

IA+1K 1A+21C ZA 2A+11C 2A+21C

21,103 JS,441 22.124 21.1 59 27.389 32,425 n.m
28,SJD ll,JS4 40,ZI0

26,918

l
j
733Jo H119 115167 110777 12007 f
gzm 'I'-"""'!--,--.,.

i
101su 1a1sJomm ll 1
!14S9S

129628
203736 215344

229 m241201

::.:.~.:==..-=--g:-=- ,______,.._,_ ==-~-.:=::=:t."' ..- ~... - ....~-----::.~

<M
72

37
.
!!
 11!/i,!,';.'!-.~

~1tJm·
®
m~mMWWti1 HEALTH ELITE PLUS . PREMIUM CHART
""'' r ...__~

31, 467 42.091 51,587 50,202 59,853 72,762

32.766 43,039 52,393 52.098 61 ,464 74,373

41,321 49,284 57,697 60,743 68,231 81, \40

41 ,439 49,423 57,837 60,998 68,481 81,326

54,089 62,286 69,130 83.622 88,628 102,289

92 78.807 82,011 86,538 123,045 122,229 115,879

,379 92,650 93,JJC 96,255 145,431141,520 155,026

,270 139,362 131,144 128.600 220,a44 205,984 219.]10

312,576 \80, 481 178,145 \90,982 312,456 322.Gell 338 ,701

336,555 195,768 191,597 204,128 339,360 348,980364,993

370,33S 217,258 210,501 222,609 377,1 82 385,944 401,958

400,352 236,5,40 227,477 239,193 411.120 4\9,110 435,123

l l l lndif. lftdrl. 1A+ 1K 1A+21 2A

11 32,666

34,047

1 1 1 1 43,281
75,747

77,459

85,068
36,674

38, 129

49,529
49,689

S0,751

59,073
61,243

62. lSO

69,218
57,821

59,946

72,749
69,924

11.728

82,023
85,726

81,531

97,826

. . 43,462 49,75959,26469,40873,09282 ,21898,081

1 1 1 57,049 66,447 76,319 85,192 103,336 11»,153 126,156

l
98,621 99,079 102,090 1S4,982 lS0,504 164,798 117,907 117,756 120,603 185,827 179,543 196,546 1
f

1- - -
1 1 1 1 149,0Jl l39,S94 137,003 1ao,uo 168,4\S 1sJ,942 2ss,ss1 265,565 2sz,ssa
19J,37Cl90,569204,266335,1S43'l5,920362,917235,0222J0,844246,9074Cl!,509420,794441,J98 t3
209,776 205,005f Z18,375 364,0n J74,1l) 391.134 254,711 N8,17t 263,840 443,161 454,659 475,263 j
2n,s11 22s,29s 2Js,204 404,609 413,797 430,793 2s2.119 212.290 2e7.411 491,400 so1,a01 s22,40s C

___...._.
J
_
- 25J,580243,553Z56,046441,!2J449,480466,477308,256295,290 309,888537,40054S,75556l,360

:::::.::~ ..... -
.:::...· -:..:·· _ ., " . ·-""' ,_..,___ ._., ... .__.__ ... ::.::: ,
 . . 7.J9J

,.~, 10,927 1J.8!M 10,9 27 13,694 18.JSJ 8,739

II . . 9,Z06
11,40-4

12,251

12,251
14,299

15,018

15,018
11 ,880

13,574

13.S74
14.704

16,142

16,142
19, 163

20,602

Z0,602
9.SZO

11,047

11,047

13, IJB 16,473 19,0 22 21,069 22 ,929 27,19S 16,047

21 ,500 23,295 31 ,124 31,475 16,341 Zl,755

27,318 28,240 42.160 41,366 46,232 J?.677

"
·
"'
26.695

. . 37, \32 35,338 59,460 55,561 S0,427

I
1 1 1 48,941 M,509 B6,087 90,241 96,328

59,255 95 ,799 99,732 m ,an u,m

62,543 66.?07 110,026 113,636119,72] 76,573

72.590 70,0 127,709 130,911137,004 81,968

1
1126916,618 21,17216,61821,172

1~28l 17,3S9 21,801 18,099 22,429 29,3 16 15,411

I
14,192 1U26 23 .046 21.033 24,921 31.806

111 14.292 ,a.az, 23.G46 21,033 24.921 31.806

1111 20,103 25,650 29,495 33 ,198 35,911 43,432

. . l0.7l4JJ,67536,31 649,24749 ,5 5357,074

. . 42,S4043,12044,344 B508S82,82392294

1
. . . 9,37656,58855,78295013B85 0596026
78370 79848 137897 144218 153547 99 155 99658 109309 11H83 182434 194323

87115] S654l H031 153287 159258 m687 1102361 109409 118838 r 19398£ 201493 213 382

100025 97904 1051341760101814651908941265961?3806 132908222779229631141521

• 115059T 111133T 118062 202.468 207322 216751 145&45 140.!.69 149291 256307 2823118 274287

-•"' --·.. ""- ~" ..':.,;,, ...~~;;~;;"::.~'1,' .~:;:.'·"~ ~:..-·::-.::: __ ,._ .. __ ,_ ..... ................._
 .....___ " ---
/CICte lombard

......_l,,.!P:"-ij"l,..~'!l'lij..,J~"1,~W"'
.ffl!l'!tt"h)"'!f..
lt!!'l'!!ljj
® HEALTH SHIELD PLUS • PREMIUM CHART

l•di•. 1A+ 1K 1A•2K 2A 2.l+IIC 2A+2K

1111 13.507 19,830 14.JSO 21,644 21,477 21,701 27,690 36,692

1
13,91220,133 2S,8S l 34,11315,2102 1,98027,7&322,3732S,2&037,263

20,973 25,280 34,614 42,SSli 22,910 27,600 32,537 33,613 37,807 46,809

21 ,127 r 25,408 34,Ss.4 43,028 23.077 27,739 32,676 33,865 38,057 46,996

1 1 1 1 31,277 35,819 51 ,829 60,689 34.176 39,128 43,247 54,562 S6,626 66,3\6

81,249 90,095 57,854 SB,022 59,349 SZ, 321 88,8151 98,492

63,333 61 ,~3 IOol,655 69,3\1 67,41\ 67,443 110,889 10',861 114,J!M

. . 102.62993,48789,026164,821l50,1 411S8,69Q112,272 102,24597,2l8180,30l1S4,225173.S78

. . 136,0011l1,812140,151239 ,455245,58325li,401148,799 144,196\SJ,205261,9!M268,697280,537

1
147,04914\,SJS 149,652258,899264,586275,404160,984 154,919 l6l,684283,440289,655301,495

161,901154,605 162,4 25 285.040 290,131300,950177,347 169,318 \77.756312,237 317,799 329,639

179,040 169,6831 177,164 315,204 319,610 330,428 196,284 185,982 \9'4,042 345,565 350,369 362,209

11111 lndiw. 2A .. 1K 2AHIC ln div. 1A + 1K 1A+2K 2A

1
15186 19.96929.26037,161?9,339

1&:381 20.595 29.717 37,649 J0,253

24,110 J1 .m 37,422 44,093 45,ssz

. . 2092 50,66S31 .37937.613 44.284 46,006

1111 JG.893 42,2D6 46,758 58,896 71,551 46.583 53,210 58,761 74,35S

H,844 72.779 72.895 119,740 113.206 123,485 94.656 91,938 91,869 151,427 143,012 156,051 J
- 121,300 110,425 ! 10S,113 194,799 177,3991 187,482 153,611 139,632 132.687 246,520 224,09? ] 237,lJO i

1
160,178 155,76 4 l 165,599 Z83,090 290,309 303,01! 203,523 197.D69 209,310 358.369 367,129 383,570 li
173,906 167,317 176,839 306,195 312,889 325,659 220,146 211 ,696 223.llllS 387,624 395,719 412,160 1'
191,~3 182,838 192,056 337.236 343,224 355,995 242,478 231,lO 2'2.811 426,930 434,131 ~50,573 .

-~-
-----·--ao..·--:--·--~-.. ----~- ,._. ____- .. -_, _,. . ..__"':."=·==:::'"'....=..........=::;:-
- 211 ,929200,77B20i,589373,11 6J7B,2a9391 ,059268,2882S4.()61265.(.:17472,354478,52l494,965 1
 HEALTH ELITE

o.,,cn ............. "-

f'fDWIMII......
40.0-.,, t,"-Pad)
tn-

---
--
..... 11onie.,,.c-
11,-.-q,-d) -....=- .....=...........-
tum,-..,

tH,!OI

'=.....=
-
U,000-
Newlkn;
tl0,000
t\0.11111

n,000,...,
I~"""°" tl Q.000 .,..
~MIIO.. SI UpltWhlSI

HEALTH ELITE· PREMIUM CHART

11,iM II.Ml <UM lUOJ lJ.OQ M,.lll

11.tl'I ... <U111 OJ,. . -1 15,Ul

JUI' OQ.:i,,J 01)'1 ll.ll!I M.CI IUOI

ll,9U JII.IIJ t1,ln <I.ts! tt.OiO U,114 lUlt llll,JOJ '1)11 11,JY k ,tOI M.1<11

JS.11:1 0....1 "-U1 IUII SI.Ill ii.al OQ,MG <I.Ill S\tll 11,,00 If.OU 11,111

I\Xl:I 111.0ll lt,lQ - 11,110 ll»s A,Jll II. Ill k.U11 1U<1 ..,IOI..,.

11.110 -IU.11" II.DI 11,111 11,MI M,,lll 11.12;! , .... IOll,1111-111.lfl

l'),t<!I 11.J11 1<.m 111,111no.mu1,m 11.1!,4 . ,. ..... l<Cl,Jl1 IM,1111 ltl./W

Q,ffl ... !DI.UI HJ.IIO , ..... l!'UU

101,l,tl IIIJ,M Ill.fl& 1JUl1 111 ... 10,1• UUO< •?t.llol 111, IIS ll<,1 1'1 n:1.IIS ZU,ACI
m,1r.; HUY m.oio ,-.,a 101,1Jli 111.M< "l.llil l'11,!r.1 Ill.Ill JU,111 ?J!,10< ZIUIJ

.___
________ ...-________
. ________ . _____... ___ . __
111,211 IU,111 11011 11$,IIGIO 114.IM 19.ll!

__ _____
---<il6St"-'<1'_, __
---·---
··--- . __
-----------·
..,
--------•aa-••-•G:1-0ICLll,- ---·-·---·-··-·--
.,
- -------·-"-·--
..,.
__ ,. ______ ,. .... ...
....... _ ... .,, .. . .,_ _ _ _ , _
.. _ _ _ _ _ ..,_,. .. _ _

OIC"'-l o
==~.·::.:::-.::-.:.·.:.::.::.."~-=---:=-:..~.:-=-.:==--=
:,.~.:,:.::,:::: • - ,.. r..,. om,.,m. m ..,_-,:,,..._ - ---
 ---
t, 1C1C1C1.ormm1

h#-iHIIHHIAU@

a.-.Pr....._ .. , _ 111i..-
PEOwlililgpOnN
fOtdnd & ~

lliiilicion Ir tMrition · - - - - - lrlboil:

Koollt,Auit1ltlce lrlboil:

--....
-...
NowllomlllbyC--
fl-wtitinQporiodl
-"""
"'-==t~OO~-
.
"""'"''"""
...
tJ.DOOporU'f'

HEALTH ELITE PLUS • PREMIUM CHART

lUM 41.MO U,lll 11.N u.MS 1',JOT -.11, <I.Ml 11,1q i!,U, H.'10 ~lH

"-041 44.MI r.<.Jn U.tn &I.Ill TI,'~ x.111 ~11 , n.no II.NI 11 ,1n 11.§31
<Utl 11 ,SII IIU1.U,lll 11.11115J111 <U2'1 YJ!l ff,111 12.1" ll.lln IH11
U,Mt 11,1n ID.iii 11.. 11.111 1UU <l,M Y.21' llQ ll9't IUll -•
II.NJ II,. . 11<11 11..>41 a.<tt !GI.Ml .._ .. , lUII fi,112 lm.ut l. . lU lltlY
U.144 ,u11 tl,l,U 1-.111111.11& HOit IUlll 10,.0li 101,Ml lY.lll 11-011 IIUll
N,ill IUIJ1 ,a.-11-1.m l!ICUIM !M.1" 111.IGI 111.N l lC,.C, lfi,1111 l!'Utl IN..._
!ti.al lJUM m.OOI , . . , noJIII m11s ,-.uo 111.,,, ll1M1 1,uu NUii m.w

:: ::7::; :: ::: :: ::::1r::: :~: :,:

llUXI U0.50 21M.JII ut,15<

ffl.1111 IIUU
JiJ..111

.. l,lZJ ...... Mt.<JJ

ii.m1,o. ... 1.._m,,ou11t10;1M441,J11

-IM Mm
_ _-
_ -_
- u,.ooa
.,Gn _ _ _YI,-..
Ml,~ •-
::
 ICICI LOMBARD
COMPLETE HEALTH
INSURANCE

HEALTH SHIELD

"'9 HospRaiution In built

l'osttlospitllisltion In built
~l'rocedurt1 andTr11tmtn1 In built
PEOwlil-,g penod In built
tc.c•..i&Acc~fll)

UptoSI Uplo SI Uplo10 llkhl

ASl ~tor
Adclitionll Slm lnsurtd(ASt)
t-,.ncySemc:11
1'10,000

ValutAHMS1rvlc:1fVASI
Ht-"'Chlck•UI) In built
Onlint CllalwitllOoc:tor In built
E·Stcond~ In built

Weloles1 1'rogr1m
OptiailllAdclOn
OptionllAddOn
WorldWde COYII OptionllAddOn l)ptlQlllj(forSI
tl'llnnld:Ha Copa~f l OllklulOffl'/1
Supa- No cllim llonu1 OptioMIAddOn
ttospilllOtiy C11h OptianllAddOn t 1,000pe!'day '2,000pe!'dl'f 0 ,000Jl'l'dly
Conv~s.n.f,, OptiailllAddOn 1'10,000
Nw-...11Hon. OptionllAdclOn '2,000 .... day "3,000,-day "3,000,-dlly
Compmionltt ViS<1 ,10.roJ
Critieallhff llar ldoJa ontvl
Optior\llAddOn
OptionllAddOn UptoSl "'·""
U,,, S1
Penon11 Aeei6ent (fo, fdult1orly) OptionllAddOn UptoSI UpioSI

HEALTH SHIELD - PREMIUM CHART

1.l. t- 1K j l,\ t- H IA t-il IAt-JK

""'"' 1U11 1l,H4
U,

10.tJJ 1:UM 11,)~J l, IH IU1J 11,11)

::::I:::: IJ,414 14,0M

19,41?
:;::!:J:::
21. ~ l'U~ Ji.lH J l,4~ M,3' 1
2t•• run
n.m H_O'.,I 11, IOI :it,m ll.ffll
IU M 21,Sll j 2U -O '2,760 , ,. u.m U.111 U, lN 3',lll i>l,3'1 S0.04 SU U
)l,131 35,IU )UH Sl.460 SUfl IO,Ul 4\,412 0 ,424 42,110 Jl,IOl ll.141 IJ,Ui

"'"o ,un 111.m

... ::1::: : :: :~:

11.011 N ,HI H,HI IO,HII 611.201 111.1,2~~ 110.131 111.SH
M,H! 12,0SI 111,241 m,r.,1 121,lOl

IC,IOS 13',lH llU U 141.112

___
90,'l)ol 1114,711 11,lSll m ,111

.... __ ______
RMtt .. ~ ol GST.Pali<v"--1-.

.........
5-......_. _ _ _ 1__. ,,.,.. --.11c11nt1,11o---•-•---,
""_""',.,_ ,.,_,. . _.,"'-" .., ,.,"''"""--,.,..._,_
.,.,..,,,,... _,._,_
- - . . - - - . . ,,,,..,.. . -"",__...,. __ ,_....,g _ _ ,....,_...,.., _ _ _ ,_
.. ...,.,. _ _ _ _

l><IOol_CIC___
........ -._....,.. •..,,.,...... ...,..,..,_ .. __ ,,_,,,_.~- . . .,-_ ___ _,,_
Uot.111--, ICICl- ... ~ - - . • I C I C l a . o . ... lo - - l CICl l-GICllol _ _ _.._,.IIIQO-,_IOICICl~GICLIO fllo
....
ICI -C-tl_..,..'-_~Offic:o
~=~1-~"i~~
-
':':""'::: =:-·::.-:"'o,=m•:: :-'~~1ti~~~c.:.=:::
~ -U.o.eom A~/10151
 HEAL TH SHIELD

L
"'9HospRaiution Inbuilt
l'osttlospitllisltion Inbuilt
~l'rocedurt1andTr11tmtn1 Inbuilt
PEOwlil-,gpenod Inbuilt
tc.c•..i&Acc~fll)

UptoSI UploSI Uplo10llkhl

ASl ~tor
AdclitionllSlmlnsurtd(ASt)
t-,.ncySemc:11
1'10,000

ValutAHMS1rvlc:1fVAS I
Ht-"'Chlck•UI) In built
OnlintCllalwitllOoc:tor In built
E·Stcond~ Inbuilt

Weloles11'rogr1m
OptiailllAdclOn
OptionllAddOn
WorldWdeCOYII OptionllAddOn l)ptlQlllj(forSI
tl'llnnld:Ha Copa~f lOllklulOffl'/1
Supa-Nocllimllonu1 OptioMIAddOn
ttospilllOtiyC11h OptianllAddOn t1 ,000pe!' day '2,000pe!' dl'f 0 ,000Jl'l'dly
Conv~s.n.f,, OptiailllAddOn 1'10,000
Nw-...11Hon. OptionllAdclOn '2,000 .... day "3,000 ,-day "3,000,-dlly
Compmionltt ViS<1 ,10.roJ
CritieallhffllarldoJaontvl
Optior\llAddOn
OptionllAddOn UptoSl "'·""
U,,,S1
Penon11Aeei6ent(fo,fdult1orly) OptionllAddOn UptoSI UpioSI

HEAL TH SHIELD - PREMIUM CHART

n,,s1 n.sn JU" M,lw J1.n1 ,un

" ,2'12 11,121 H,1141 21.0U 2'.tll 11,IOI 11.ts1 n.sn 2uat zu• 11.nt :sun
20.1'0> 2uso n.os n.1• :is.111 0.02 Jt,011 IU O U.0$0 ll,1 11 IS, ltG k ,Ml
:,0,JJ( JUJS 3U II U,JO IUU Sl.DH N,111 11,111 15,104 11,IU H,01 11,MI
12,\411 0,120 U,144 H.UJ 15,IOI 11,lJO k,™ SS,111 N,OH H,llJ U.ZM
11 ,m 111.:iu 1zo,2 11 111 ... m ,a

H,JJ11 JUO N,!i l I m,nJ 1'-'.111 ISJ,UJ tl,lH tl."8 10,UOI 114,m Ill.fl' 11&.Hl

ll,115 IUO " ,OJI lU.211 m,ne 11UI J 110.t• Hlt,4111 1lllll IH,IN 2111.•U t1Ult
1Cl0,ll?S 11,904 105,IJ( 11$.010 m,qs ltll,tt,I nuw 1H,IOS UUOI m.n, n,.11:u JCl,lJI

___
IIS.O!i9 11 1, Ul 111,0&2 202,.U 201..W lll,751 14S,kS UO.SU 10,lt1 M,)OJ 2'2.ltl t7C.2U

.... __ ______
11Mtt .. ~o1GSI.Pali<v"--1-.

.........
5-......_. _ _ _ 1__. ,,.,.. --.11c11nt1,11o---•-•---,,,..,.,..,,,,
""_""',.,_ ,.,_,. . _.,"'-" .., ... _,._,_
"''"""--,.,..._,_
..... , , _ _ _ ,.,,,,..,__ _ "",__...,. __ ,_....,g _ _ ,....,_...,.., _ _ _ ,_ _ ...,.,. _ _ _ _

!><IOol_CIC___
........ -._....,. •..,,.,...... ...,..,..,_ .. ___ _,,,_.~- . . .,-_ ___ _,,_
Uot.111--. ICICl---~--.IOICICla..o. ... lo - - l CICll-GICllol _ _ _.._,.IIIQO-,_IOICICl~GICLIO Tllo
... ,....
ICI -C-Ol-.... '--~Offic:o
~=~1-i:"i~~
-
':':""'::: =:-·::.-:"'o,=m•:: :-'~~1ti~~~c.:.=:::
4j...-u,.eom A~/!01St
i•s1j1i,il f 1
1
!h !1ljt ! ., I ;ill l i i ! g t ll; !. 1
&)
1int11n i ; ; 1
111!1111IUI f' 1HH/
1:1i!l!U1i -4;l
jHlflll'11lfl[.f1Ht'Hi!•flfi f(ii1Hf
i IllI 11i,~ Jf 111[ ;'·/J/i1
i ' r E I
i.inl'
111,,.,1·il
•. 't H H
·Ca.

' ;'I'·i''i!,I
slip I • ,'. •i •,
1111111111 lllll1, m1m1m1m1,11,1,1,11m1m1m1,1 m1m1,
if 1!11t! '. ! :
•1i1!1•• .I li f ;
'jlB 1f!j ' sl 111 11 ~I I 11 11JG
·h
'I'·I1l,,1., l!lilfl I ·I I1,1:uimrl I!
"II•·
,,••s11,,1
ilh!il!i !
n1
f ,lil;l,I
!l!111fl1IH11l1l1lnfimrlil!, ,,,, ,, ,,,,, ,,,,sl 1,1,1,1,l,l!l,I 11
l:·,lh!J I
isll•!!lj ; ; i
1
,1,1ihi,1:
I i1B1 If
'
11:lfl I11 I l1lnfimrl If ti 111 1I Ill I 11 11..
l'iiliil;
,hl,Ml
,
 ICICI LOMBARD
COMPLETE HEALTH
INSURANCE

HEALTH SHIELD PLUS

EidiNBifalN
"'9 Hospitliution Inbuilt
l'ost tlospitllisltion In built &Od11'1
~l'rocedurt1 andTr11tmtn1 In built
PEO wlil-,gpenod In built
tDecllr9d&Accepted)
ln"-tilnl A'ltlSH hoi.pit..liHtiOII In built
Donor ~ In built UptglOw.i.t

ASl ~tor
AdclitionllS!m lnsurtd(ASt)
tmMtMCySemc:11
, 10.000

VM AddffS1rvlc:1 fVAS I
~ChlckUp In built
Oollint CllalwitllOoc:tor In built
E,Steond Opinion In built

Welness l'rogfam In built

WorldWde COYII Inbuilt

tl'llnnld; lla CDPl~I
Supa- No cllim llonu1

..
ttospilllOtiy C11h OptionllAddOn '1,000perd1y
Conv~Btntfil ~ A d d On , 10.000
Nw-...11Honw
Compmionltt ViS<l
OptiorlllAddOn
Optior\llAddOn .,,,
'3,000perctly

Critieallha OptionllAddOn
""'°'111 Aeei6ent OptionllAddOn

HEALTH SHIELD PLUS - PREMIUM CHART

' 1
"""'" ..._ j 1.1.+ 1Kj 1A t-JII ti, tl,-t1 l1,lt- lK

n.m :: : .: ~(~:H
J I
1UII ll.)02 2ll 10 U,lM H ,11~

1u11 1J,n1 :,0.011 ZO.HS n .711 n.~, SO.Ml

1,.110 n .1,, JS.11\ U,422 U,Ot! 45.$U 51."11 0 ,551

1,.m :ru ~T1s.m ,,.n, n.1,, u ,n. 1t,IIOI s1.t02 n.llOI

31,ffi IZ,281 4lJ!il ~.w U,JIO H,111 14,JSS n.m tc,KJ
n .lN I•u21Jn.1n M.111 tUN ,oun 1uo, n.ou tc,110 ne.ou m.no 1:M.JH
14,IU ll,1/f 11, ffi 111,l~ 11 UOI IU,415 k ,l!o& 11,ffl I I.Ill 151 ,UJ \U,01 2 1SI.O!i1
121.,00} 10,u s} ~,,, lH, IM 111,:m 111,, 11 IIU11 IH ,U ! nun 141,5:ro !U,DU n1.1 111
110. 111 1~s,11,4 m .)H m .o,o no.m m o11 ZIii.Hi 111,0H 20U10 ~ .Mt MJ,1n 31U711

:::1:::::1::: ::: ::1:::: no,u,

!H,'11
JIUM 2!J, I05 111,1!1 HUii 412.IIO
!11.lO 2, 2.111 •H.1111 ,u.m 150,SlJ

11un Tzoo,n1j 20u11 11u11 nun nu,•,1 ZU.2'1 25,1,061 !U,001 1JU5' '11.SU •M.MS
RMtt . . ~ ol GST.Pali<v"--1-.

5-......_·-
"..,
__ - -1
, , _ _ _ ,.,,,,.., --•1fl--.11c11n11,11o---•-•---"'•io1<Klll'•oo-•-r-
...•-•-•-""'••-"-,uoo",_,-.,._.,"'-"•--,--,--•"''"
.. . -"",__...,.
... __ ,.,._._, _
__ ,_....,g _ _ ,....,_...,_, _ _ _ ,_ _ ...,.,. _ _ _ _

....
........ -._....,.. •..,,.,...... ...,..,..,_ .. __ ,,_,,,_.~- ICICI -C-o1-.... '--~0ffic:o
l><IO!l_C___ . . .,-_ ___ _,,_
Uot.111--, ICICl- ... ~ - - . • I C I C l a . . o . ... lo - - l CICl l-GICllol _ _ _ _ _ lllQO_,_IOICICl~GICLIO Tllo

~=~1-~"i~~
-
':':""'::: =:-·::.-:"'o,=m•:: :-'~~1ti~~~c.:.=:::
A~/10111 ~ - U.o.eom