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OPD Coverage Health Insurance Plans |
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3- ICICI Lombard Health Insurance - Health Advantage Plus |
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Exclusions valid for the first 30 Days: |
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Treatment of the following diseases:
- Cataract (limited to Rs 20,000 per eye)
- Benign Prostatic Hypertrophy
- Myomectomy, Hysterectomy unless because of malignancy
- Hernia, Hydrocele
- Fistula in Anus, Piles
- Arthritis, Gout, Rheumatism
- Joint replacement, unless due to accident
- Sinusitis and related disorders
- Stone in the urinary and biliary systems
- Dilatation & Curettage
- Skin and all internal tumors / cysts / nodules / polyps of any kind, including breast
lumps, unless malignant / adenoids and hemorrhoids
- Dialysis required for chronic renal failure
- Surgery on tonsils and sinuses
- Gastric and duodenal ulcers
- Deviated Nasal Septum
Note:The OPD claims can be made only on a reimbursement basis. You can lodge a claim only once during the Period of Insurance, i.e. 90 days after commencement of policy and 30 days after expiry of the Period of Insurance. |
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Pre-existing Disease Exclusion: |
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Any illness / disease / injury pre-existing disease before the inception of the policy. However, this exclusion ceases to apply if the policy is renewed with the Company for 2 consecutive years. |
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Permanent Exclusions: |
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- Non-allopathic treatment, pregnancy and childbirth related diseases, cosmetic,
aesthetic and obesity related treatment.
- Expenses arising from HIV or AIDS and related diseases, use or misuse of liquor,
intoxicating substances or drugs as well as intentional self injury.
- War, riots, strike, nuclear weapon induced treatment.
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Exclusions for OPD (Outpatient Department Expenses): |
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- Suicide or self-inflicted injury
- Alcohol or drug abuse
- War, riots, nuclear related hospitalisation
- Non-allopathic treatment, experimental and unproven treatment
- Expenses arising from treatment of HIV/ AIDS or related disease, use or misuse of alcohol and other intoxicating substances and intentional self-injury.
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