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ICICI Prudential Hospital Care II Plan

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This plan has been withdrawn by the insurance company and is no longer available for sale.

ICICI Prudential Hospital Care II Plan

ICICI Prudential Hospital Care II Plan is a comprehensive Health Insurance Plan with 4 variants. It is a Traditional Plan without Bonus facility.
 
How it works – In this plan, premium needs to be paid for the entire policy tenure and there is guaranteed insurability on payment of renewal premium without additional medical requirements.
 
This plan pays for benefits like Daily Hospitalization Cash Benefit, Intensive Care Unit Benefit, Surgical Benefit for over 100 surgical procedures, Non-Surgical Benefit, Recuperating Benefit of hospitalization for more than 7 days, Prolonged Stay Benefit for loss of income, Free Health Check Up every 2 years, etc. which can be availed over and above a regular health insurance plan. There are 4 variants of this plan where the Daily Hospitalization Cash Benefit is Rs 1000, Rs 2000, Rs 3000 and Rs 4000 respectively and other benefits increase proportionately.
 
Being a pure health insurance plan, there is no death, surrender or maturity benefit under this plan.
 
 

Key Features of ICICI Prudential Hospital Care II Policy

  • It is a Comprehensive Health Insurance Plan which can be availed over and above other health insurance plans
  • In this plan, there is Family Floater Option which covers self, spouse and upto 3 dependent children
  • This plan offers Guaranteed Insurability for lifelong
  • The basic benefits in this plan are:
    • Daily Hospitalization Cash Benefit
    • Intensive Care Unit Benefit
    • Surgical Benefit for over 100 surgical procedures
    • Non-Surgical Benefit
    • Recuperating Benefit of hospitalization for more than 7 days
    • Prolonged Stay Benefit for loss of income
    • Free Health Check Up every 2 years
  • This plan offers additional Daily Hospitalization Cash Benefit and ICU Benefit
  • There are 4 variants of this plan where the Daily Hospitalization Cash Benefit is Rs 1000, Rs 2000, Rs 3000 and Rs 4000 respectively and other benefits increase proportionately
 
 

Benefits you get from ICICI Prudential Hospital Care II Policy

Death Benefit – There is no Death Benefit in this plan.
 
Maturity Benefit – There is no Maturity Benefit under this plan.
 
Hospitalization Benefits – In case of hospitalization of the Life Insured the following benefits are paid:
  • Daily Hospitalization Cash Benefit subject to a minimum of 24 hours of hospitalization for a maximum of 90 days per policy year
  • Intensive Care Unit Benefit if the Life Insured is admitted to the ICU subject to a limit
  • Surgical Benefit– a Lump Sum amount is paid on any of the 1000 surgical procedures mentioned subject to a limit
  • Non-Surgical Benefit- an additional Benefit amount is paid for non-surgical hospitalization
  • Recuperating Benefit- A post-hospitalisation benefit amount is payable to help the Life Insured with recuperating expenses like follow-up tests, medicines and consultations
  • Prolonged Stay Benefit- is payable after a continuous stay of more than 30 days in the hospital
  • Health Check Up- Complimentary Health Check-up will be available once every two years after completion of the first policy year
 
Income Tax Benefit - Health Insurance Premium paid up to Rs. 15,000 is allowed as a deduction from the taxable income each year under section 80D, where the limit is Rs 20,000 for Senior Citizen.
 
 
 

Eligibility conditions & other restrictions in ICICI Prudential Hospital Care II Insurance Policy

 
Minimum
Maximum
Daily Hospitalization Benefit (in Rs.) per day
1,000
4,000
ICU Benefit (in Rs.) per day
1,000
4,000
Non-Surgical Benefit (in Rs.) per day
1,000
4,000
Recuperating Benefit (in Rs.) per day
3,000
12,000
Prolonged Stay Benefit (in Rs.) per day
1,000
4,000
Health Check Up (in Rs.) every 2 years
Upto 4,000
Policy Term (in years)
10
Premium Payment Term (in years)
Equal to Policy Tenure
Entry Age of Life Insured and Spouse (in years)
1
65
Entry Age of Dependent Children (in years)
90 days
24
Payment modes
Yearly, Half yearly and Monthly
 
 

Sample illustration of ICICI Prudential Hospital Care II Plan

The below illustration is for a single healthy male opting for Plan B, i.e. Rs 2,000 of Daily Hospitalisation Cash Benefit

ICICI Prudential Hospital Care 2 Plan Sample Premiums

 

Additional Features and Benefits of ICICI Pru Hospital Care II Plan

Riders – There are 2 additional benefits that can be availed with this plan of additional 100% payout of:
  1. Daily Hospitalization Cash Benefit and
  2. Intensive Care Unit Benefit
This however does not change the payout limits for other benefits in the plan.
 
 

The exclusions under ICICI Prudential Hospital Care II Plan

The basic exclusions under this plan are:
  • Pre-existing condition unless stated in the proposal form and specifically accepted
  • Permanent exclusions as specifically stated in the policy
  • For conditions of diabetes or hypertension or both, if disclosed at inception and accepted for cover, an investigation/treatment for these conditions and any complications arising from these conditions (including but not restricted to Ischemic Heart Disease and Renal Failure) shall be excluded for the first two consecutive policy years from the policy issuance date or revival date in case the revival is 60 days after first unpaid premium
  • Any expense incurred during the first 2 years from policy issuance date or revival date in case the revival is after 60 days from the date of first unpaid premium shall not be payable for the following diseases/surgeries & any complications arising out of them:
    • Deviated Nasal Septum/ Nasal & Paranasal Sinus Disorders
    • Diseases of Tonsils / Adenoids
    • Surgery of Thyroid Gland excluding Malignancy
    • All types of Hernia
    • Hydrocoel /Varicocoel / Spermatocoel
    • Piles / Fissure / Fistula-in-Ano / Rectal Prolapse
    • Benign Prostatic Hypertrophy
    • Menstrual Irregularities, Dysfunctional Uterine Bleeding
    • Hysterectomy with or without Bilateral Salphingo - Opherectomy excluding Malignancy
    • Uterine Fibroid
    • Calculus Diseases
    • Prolapsed Intervertebral Disc
    • Retinopathy / Retinal Detachment
    • Peripheral Vascular Disease due to Diabetes / Diabetic Foot
    • Renal Failure due to Diabetes
    • Osteoporosis / Pathological Fracture
    • Cataract
    • Joint Replacements except due to an accident (one Knee or one Hip Replacement in a Policy Year)
    • Congenital Internal Disease or Anomalies or Disorder
  • Treatment directly or indirectly arising from or consequent upon war, commando or bomb disposal duties or training, terrorism, invasion, acts of foreign enemies, engagement in hostilities, active military and police duties such as maintenance of civil order whether war be declared or not, civil war, rebellion ,active participation in strikes, riots or civil commotion, revolution, insurrection or military or usurped power or travel by military aircraft or waterborne   vessel, and fulltime service in any of the armed forces
  • Diagnosis and treatment outside India. However, this exclusion shall not be applicable in the following countries: Australia, Brunei, Canada, Dubai, Hong Kong, Japan, Malaysia, New Zealand, Singapore, Switzerland, UAE, USA, and countries of the European Union. The company may at its discretion review the above list of accepted foreign countries from time to time. Claims documents from outside India are acceptable only in English unless specifically agreed otherwise, and duly authenticated
  • Circumcision (unless necessary for treatment of a disease not excluded hereunder or as may be necessitated due to any accident), Vaccination & Innoculation
  • Treatment which results from or is in any way related to sex change or cosmetic or aesthetic treatment of any description, plastic surgery other than as may be necessitated due to an accident or as a part of any illness
  • Routine medical, eye and ear examination, laser or other surgery for correction of refractive errors of sight, cost of spectacles, contact lenses, hearing aids, cost of Cochlear implant(s), issue of medical certificate and examinations as to suitability for employment or travel or any other such purpose
  • Expenses on vitamins and tonics unless medically necessary as a part of treatment for injury or disease as certified by the attending physician
  • External and or durable medical / non medical equipment of any kind used for diagnosis and or treatment including CPAP, CAPD, infusion vhpump etc., ambulatory devices i.e. walker , crutches, belts ,collars ,caps , splints, slings, braces ,stockings of any kind, diabetic foot wear, glucometer / thermometer and similar related items and also any medical equipment which is subsequently used at home
  • All non medical expenses including personal comfort and convenience items or services such as telephone, television, special mattresses, personal attendant or barber or beauty services, diet charges, baby food, cosmetics, napkins , toiletry items, guest services and similar incidental expenses or services
  • Costs of donor screening or treatment including surgery to remove organs from a donor in case of transplant surgery
  • Any dental treatment or surgery which is corrective, cosmetic or of aesthetic in nature, filling of cavity, root canal treatment, and treatment of wear and tear, any orthodontics or orthographic surgery, or temporo-mandibular joint disorder, except as necessitated by an accidental injury.
  • Convalescence, general debility, “run down” condition or rest cure, congenital external diseases or defects or anomalies, sterility, any fertility, sub-fertility or assisted conception procedure, hormone replacement therapy, intentional self- Injury/suicide, all psychiatric and psychosomatic disorders and diseases / accident due to and or use, misuse or abuse of drugs / alcohol or use of intoxicating substances or such abuse or addiction
  • All expenses arising out of any condition directly or indirectly caused by, or associated with human T-cell Lymphotropic Virus Type III (HTLD - III) or Lymohadinopathy Associated Virus (LAV) or the Mutants Derivative or Variations Deficiency Syndrome or any Syndrome or condition of similar kind commonly referred to as AIDS, HIV and its complications and all sexually transmitted diseases
  • Expenses incurred at hospital primarily for evaluation / diagnostic purposes, wherein such tests are possible to be carried out on out patient basis and which is not followed by active treatment or intervention during the period of hospitalization
  • Any treatment arising from or traceable to pregnancy, childbirth, miscarriage, caesarean section, abortion or complications of any of these including changes in chronic condition as a result of pregnancy, tests and treatment relating to Infertility and in vitro fertilisation. However the exclusion does not apply to Ectopic pregnancy proved by utrasonography/ diagnostic means and is certified to be life threatening by the medical practioner
  • Naturopathy treatment, unproven procedure or treatment, experimental or alternative medicine and related treatment including acupressure, acupuncture, magnetic and such other therapies, ayurvedic, homeopathy, unani, reflexology, bonesetting, herbalist treatment, hypnotism, rolfing, massage therapy, aroma therapy, steam bathing, shirodhara and alike treatment under ayurvedic treatment or any other treatments other than allopathy /western medicines and any treatment taken at home, health hydro, nature care clinic or similar establishments
  • Expenses incurred for investigation or treatment irrelevant to the diseases diagnosed during hospitalisation or primary reasons for admission, private nursing/attendants charges incurred during pre-hospitalisation period or posthospitalisation period, referral fee to family doctors, out station consultants / surgeons fees
  • Genetic disorders and stem cell implantation / surgery.
  • Any treatment related to sleep disorder or sleep apnoea syndrome
  • Only one coronary angiography is payable in a policy year except in case where a Coronary Intervention has been undergone after the first angiography
 
 

What happens if?

You stop paying the premium - If the policy holder stops paying the premium, the policy lapses and all benefits cease.
 
You want to surrender the policy – There are no Surrender Benefits under this plan.
 
You want a loan against your policy – Loan facility is not available under this plan.



 
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