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For Comparative Insurance Quote: Om Plaza, 430/7, 1st Floor, Sant Nagar, East of Kailash, New Delhi-65
Phone: 011-41324957, 41623784, Mob:+91-8447757651 & 53 Email:
OPD Coverage Health Insurance Plans
Last Updated On- 05, April 2012
(1) Who offers OPD Coverage as a part of Health Insurance Plan   (2) Policy Wording/ Proposal Form/ Brochure
(3) Product details of Various Companies for OPD Coverage Insurance Policy
General/Health Insurance Companies Products
3- ICICI Lombard Health Insurance - Health Advantage Plus
Exclusions valid for the first 30 Days:
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.
Pre-existing Disease Exclusion:
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.
Permanent Exclusions:
  • 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.
Exclusions for OPD (Outpatient Department Expenses):
  • 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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