Munish ICICI Report

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SUMMER TRAINING REPORT-:

JUNE 2009- AUGUST 2009

A project report submitted to Chanakya Institute of management, in partialfulfillment of the requirement for the Award of

MASTERS OF BUSINESS ADMINISTRATION

(2008-2010)

Submitted to:-

CHANAKYA INSTITUTE OF MANAGEMENT, GHARUAN

COMPILED BY:-

MUNISH KUMAR

MBA, 3RD SEMESTER

CLASS ROLL NO: - 14TH



ACKNOWLEDGEMENT

The investigator fumbles with words while expressing his gratitude & indebtness

to his reverse guide “Mr. Sachin Sharma” (Area manager) in ICICI

prudential, Chandigarh for whose astute guidance & help has carried the

investigator through sweet experience of vision & field of research. I am very

thankful to their mature guidance, valuable suggestions and encouragement.

I shall be failing to do my duty if I do not extend my acknowledgement to Mrs.

Anjali Mehta (H.O.D) in Chanakya Institute of management, Gharuan under

whose guidance this report has been prepared.

Munish kumar

Roll no. 14th

Chanakya Institute of management



STUDENT DECLARATION

I “Munish kumar”, student of Master’s of Business Administration (MBA) of

Chanakya Institute of Management, Gharuan here by declare that this project

report on the study of “Level of satisfaction of doctors” at “ICICI Prudential,

Chandigarh” is submitted in the partial fulfillment for the requirement of

degree of MBA is my own efforts and not for any award of other similar title

authorized.

Date: Munish Kumar

Roll No. 14th

Palace: Chanakya Institute of Management



INDEX

S.No Topic Page No





HEALTH INSURANCE

Health insurance policies insure you against several illnesses and guarantee you stay

financially secure should you ever require treatment. They safeguard your peace of mind,

eliminate all worries about treatment expenses, and allow you to focus your energy on

more important things, like getting better. Let's learn more about the various types of health insurance available, and what the best policy for you might be.

Health Insurance policies in India - An Overview

There are several health insurance or medical insurance plans in India. These can be

divided into the following categories based on the coverage offered:

Comprehensive health insurance coverage: These plans provide you complete health

coverage through a hospitalization cover while at the same time also creating a healthfund to cover any other healthcare expenses. Click to know more about our

comprehensive coverage plan (Health Saver)

Hospitalization Plans: These health insurance plans cover your expenses in case youneed to be hospitalized. Within this category, products may have different payout

structures and limits for various heads of expenditure. The hospitalisation coverage may

be reimbursement based plans or fixed benefit plans. These plans aim to cover the morefrequent medical expenses. Click to know about our hospitalisation insurance plan

(Hospital Care, MediAssure)

Critical Illness Plans: These health insurance plans provide you coverage against criticalillnesses such as heart attack, organ transplants, stroke, and kidney failure among others.

These plans aim to cover infrequent and higher ticket size medical expenses. Click toknow about our critical illness plans (Crisis Cover)

Specific Conditions Coverage: These plans are designed specifically to offer health

insurance against certain complications due to diabetes or cancer. They may also includefeatures such as disease management programs which are specific to the condition

covered. Click to know more about our diabetes (Diabetes Care Active, Diabetes

Assure) and cancer (Cancer Care) suite of products.

http://www.iciciprulife.com/public/Health-plans/HealthSaver_Why.htm

http://www.iciciprulife.com/public/Health-plans/Selectinghealthinsurance.htm

http://www.iciciprulife.com/public/Health-plans/hospital_care.htm

http://www.iciciprulife.com/public/Health-plans/MediAssure_Why.htm

http://www.iciciprulife.com/public/Health-plans/Crisis-Cover.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Why.htm

http://www.iciciprulife.com/public/Health-plans/Diabassure_Home.htm


http://www.iciciprulife.com/public/Health-plans/Cancer-Care.htm

http://www.iciciprulife.com/public/Health-plans/Selectinghealthinsurance.htm











ICICI PRUDENTIAL PROFILE

ICICI Prudential is a joint venture between ICICI Bank and Prudential plc engaged in

the business of life insurance in India. ICICI Prudential is the largest private insurancecompany and second largest insurance in India after LIC. ICICI Prudential Life Insurance

Company is a joint venture between ICICI Bank, a premier financial powerhouse, and

Prudential plc, a leading international financial services group headquartered in theUnited Kingdom. ICICI Prudential was amongst the first private sector insurance

companies to begin operations in December 2000 after receiving approval from Insurance

Regulatory Development Authority (IRDA).ICICI Prudential Life's capital stands at Rs.37.72 billion (as on March, 2008) with ICICI Bank and Prudential plc holding 74% and

26% stake respectively. For the year ended March 31, 2008, the company garnered Retail

New Business Weighted premium of Rs. 6,684 crores, registering a growth of 68% over

the last year and has underwritten nearly 3 million retail policies during the period. Thecompany has assets held over Rs. 30,000 crore as on April 30, 2008.ICICI Prudential Life

is also the only private life insurer in India to receive a National Insurer Financial

Strength rating of AAA (Ind) from Fitch ratings. The AAA (Ind) rating is the highestrating, and is a clear assurance of ICICI Prudential's ability to meet its obligations to

customers at the time of maturity or claims.For the past seven years, ICICI Prudential

Life has retained its leadership position in the life insurance industry with a wide range of flexible products that meet the needs of the Indian customer at every step in life.

ICICI Prudential website [1]

Since the liberalization of Indian Insurance sector, ICICI Prudential Life Insurance has

been one of the earliest private players. Since the time, ICICI Pru Life has been the leader

in terms of market share as indicated by the IRDA (Insurance Regulatory and

Development Authority, the regulator for Indian Insurance Industry) at its website.

Arguably the most innovative Indian Life insurer in terms of customer services and

products, ICICI Prudential has one of the largest distribution and servicing network withover 2,000 proprietary offices & customer touch points across India. The 30,000

employee strong organization has one of the largest agency distribution in the industry.

With a growing product range to match the complex needs of the demanding customers

in a growing economy, the organization also has a history of successful.

During 2007-08, the organization's focus on rural business has proved its complex project

execution capability and strong partnerships for customer servicing.

In June, 2009 ICICI Prudential Life Insurance has decided to snap its tie up with TTK

Healthcare to settle insurance claims of its users

http://en.wikipedia.org/wiki/ICICI_Bank


http://en.wikipedia.org/wiki/Prudential_plc

http://en.wikipedia.org/wiki/India

http://en.wikipedia.org/wiki/LIC


http://www.iciciprulife.com/


http://en.wikipedia.org/wiki/Prudential_plc

http://en.wikipedia.org/wiki/India


http://www.iciciprulife.com/



Introduction of ICICI prudential Insurance Plans

ICICI Prudential has a wide array of insurance plans that have been designed with the

philosophy that different individuals are bound to have differing insurance needs.

The ideal insurance plan is one that addresses the exact insurance needs of the individual

that will depend on the age and life stage of the individual apart from a host of other factors.

Life Insurance Plans:

Under Life insurance plans, ICICI Prudential offers plans under the following major need

categories:

• Education Insurance Plans

• Wealth Creation Plans

• Premium Guarantee plans

• Protection Plans

Pension & Retirement Solutions:

The primary objective of a pension plan is to help you provide for your financial needs in

your post retirement years. You will find a Pension Planning Calculator on the site, meant

to make your pension plan review as simple as possible. The calculator is the first step inyour Pension Plan scheme, there are othe steps towards getting the Indian pension policy

you need.

• LifeStage Pension

• LifeTime Super Pension

• LifeLink Super Pension

• ForeverLife

Health Product Suite:

Under Health Product Suite, ICICI Prudential offers plans under the following major

need categories:

Hospitalisation Plans

• MediAssure

• Hospital Care

http://www.iciciprulife.com/public/Life-plans/Plans.htm


http://www.iciciprulife.com/public/Life-plans/Education-Insurance-Plans.htm

http://www.iciciprulife.com/public/Life-plans/Wealth-Creation-Plans.htm

http://www.iciciprulife.com/public/Life-plans/Premium-Guarantee-Plans.htm

http://www.iciciprulife.com/public/Life-plans/Protection-Plans.htm


http://www.iciciprulife.com/public/Retirement-Plans/why_lifestagepension.htm

http://www.iciciprulife.com/public/Retirement-Plans/LifeTime-Super-Pension.htm

http://www.iciciprulife.com/public/Retirement-Plans/LifeLink-Super-Pension.htm

http://www.iciciprulife.com/public/Retirement-Plans/Forever-Life.htm

http://www.iciciprulife.com/public/Health-plans/Health-Assure-Plus.htm




http://www.iciciprulife.com/public/Life-plans/Education-Insurance-Plans.htm

http://www.iciciprulife.com/public/Life-plans/Wealth-Creation-Plans.htm

http://www.iciciprulife.com/public/Life-plans/Premium-Guarantee-Plans.htm


http://www.iciciprulife.com/public/Retirement-Plans/why_lifestagepension.htm

http://www.iciciprulife.com/public/Retirement-Plans/LifeTime-Super-Pension.htm

http://www.iciciprulife.com/public/Retirement-Plans/LifeLink-Super-Pension.htm

http://www.iciciprulife.com/public/Retirement-Plans/Forever-Life.htm






• Critical Illnessl Pans

• Crisis Cover

Cancer Products

• Cancer Care

Diabetes Products

• Diabetes Care Active

•

• Diabetes Assure













5 reasons why health insurance is a must

Indians at greater risk • Reason 1: Lifestyles have changed. Indians today suffer from high levels of

stress. Long hours at work, little exercise, disregard for a healthy balanced diet

and a consequent dependence on junk food have weakened our immune systemsand put us at an increased risk of contracting illnesses.

• Reason 2: Rare non-communicable diseases are now common. Obesity, high

blood pressure, strokes, and heart attacks, which were earlier considered rare, now

affect an increasing number of urban Indians.

Shocking Truths

• 18% of the urban population suffers from hypertension, which leads to renal

failure, stroke and cardio-vascular diseases• 30% of the population suffers heart attacks before age 40

• 66% of deaths today are due to cardio-vascular diseases

• Almost 3.5 million Indians suffer from diabetes

• Cardio-vascular diseases (CVDs) like heart disease and stroke are the main causes

of death and disability



The Cost Factor

• Reason 3: Medical care is unbelievably expensive: Medical breakthroughs have

resulted in cures for dreaded diseases. These cures, however, are available only toa select few. High operating expenses—therapy for breast cancer costs as much as

Rs. 2 lakhs for 3 days—have restricted treatment to the richest. In fact, evenamong the affluent groups, 20% need to sell their valuable assets so they canaccumulate the required amount to meet healthcare costs.

• Reason 4: Indirect costs add to the financial burden: Indirect sources of

expense—travel, boarding and lodging, and even temporary loss of income—

account for as much as 35% of the overall cost of treatment. Most often, weoverlook this fact when planning for medical expenses.

• Reason 5: Incomplete financial planning: Complete financial planning includes

saving for an uncertain future, children’s education, retirement and the mostimportant aspect of your life – your health. Health is important as rising medical

costs, especially in an emergency, might force you to dip into your savings which

you would have assigned for your other goals. Over 40% of all Indians sell assets



or dip into existing savings to meet healthcare costs. This could mean a severe

compromise on your long cherished goals.

There is certainly a better option: A comprehensive health insurance which can take care

of all your medical needs.

Selecting the Right Plan

Sound health cover planning ensures you have access to sufficient funds to meet direct

medical expenses of the treatment, indirect expenses at the time of treatment and loss of income, if any, due to the illness.

Point to Remember: Select a health solution by taking into considerationfactors such as your income, age, number of dependants, quality of care desired, current

coverage etc.

(Do visit our health insurance planner which would help you choose a plan based onthese vital parameters)

Quick tip

When choosing a health insurance plan, ensure that the plan:

• Provide you guaranteed long-term coverage for you and your family.

• Have very clear and transparent coverage and renewal norms

• Provide a hassle free claims process

• Provide you adequate sum assured in line with your lifestyle

• Has a mix of reimbursement and fixed benefits to meet both direct and indirectcosts due to illness

http://www.iciciprulife.com/public/Health-plans/HealthPlanner_weblink_4Feb09.html





Health Insurance Products

ICICI Prudential offers health insurance plans under the following major need categories:

Comprehensive health coverage: Health Saver

A comprehensive whole life plan that covers you against hospitalisation expenses and

creates a health fund to cover any other health expenses.

Hospitalisation coverage:

MediAssure

A reimbursement hospitalization plan covering hospitalization stay and treatment. The

claim payout is based on actual expense incurred.

Hospital Care Get free quote and buy online

A fixed benefit cashless hospitalization plan covering various stages of treatment andover 900 surgeries.

Critical illness coverage:

Crisis Cover

A comprehensive health insurance policy that covers 35 critical illnesses, death and

disability.

Cancer coverage:

Cancer Care

A unique health insurance plan covering most early and advance types of cancers.

Diabetes coverage:

Diabetes Care Active

A one of its kind critical illness health insurance plan only for diabetics and covers 7

major complications for a long term of upto 20 years.




http://www.iciciprulife.com/public/Hospitalcare/index1.html







http://www.iciciprulife.com/public/Hospitalcare/index1.html






Need for the study of Health Insurance

One of the leading causes of confusion when it comes to health care reform is the misuse

and conflation of the terms "health insurance" and "health care." This sort of confusion

manifests itself throughout the debate.

Insurance is the pooling of risk. The members of an insurance plan pay a premium that is

used to help those members who face an adverse event. In the case of auto insurance this

could the cost to repair a rear-end collision, in the case of health insurance this might be

the cost to repair broken bone. Insurance as it exists is marked by two pillars:

1. Not everyone is going to be affected by bad events that drain the insurance pool

all at once. This is the assumption behind insurance that can turn it into a profit-

making enterprise. At any given moment, group X that is running insurance pool

Y is collecting more in the form of premiums than it is expending to pay for the

health costs of members.

2. Insurance is driven by the need to protect from the uncertain. If I pay a premium

to insure a car, I am paying a premium to protect that car for unexpected events;

the car is side-swiped, broken into, flooded, etc. That way, when my car does go

missing one night and is discovered the next morning pulled over on the highway

with no hubcaps and a missing passenger-side door, I will not have to pay out of pocket. It is this desire to protect ourselves from the cost of uncertainty that drives

us to pay for insurance.

These two pillars, the profit pillar and the uncertainty pillar, are the basis for the private

health insurance market. Agencies that want to make money collect premiums from

people who want to protect against risk, and periodically are called upon to spend some

of this money to help one of the premium-payers who needs coverage for some

unexpected disease or accident.

The premium a member has to pay is based on the expected cost of care for this

individual. This system leads to certain problems, among them the inability of low-

income people with pre-existing conditions to afford insurance. This is because an

insurance company is never going to charge someone with an pre-existing condition a

premium that is lower than the expected cost to cover that person. As Katherine Baicker



and Amitabh Chandra put it in their highly informative "Myths and Misconceptions in

U.S. Health Insurance":

"Try purchasing insurance to cover your recent destruction of your neighbor's Porsche:

the premium would be the cost of a new Porsche. You wouldn't need car insurance--you'dneed a car. Similarly, uninsured people with known high health costs do not need health

insurance--they need health care."

Because insurance providers are motivated by profits, they are never going to offer a

premium that is less than the expected cost of care, as this will lose them money.

However, low-income Americans without health insurance are not going to be interested

in buying health care that is too expensive for their means. This constitutes a market

failure.

This market failure is a huge barrier to providing accessible health care to all Americans.

But alongside that is the difficulty of using the health insurance market to provide health

care. Insurance is the business of uncertainty, not care. And this is a core problem: when

Americans are buying health insurance, they are buying affordable coverage for

uncertainty, not affordable coverage for health. But those who cannot afford to buy

coverage from uncertainty still need coverage from health-adverse events. Thus, they do

not buy health insurance and in addition to living with uncertainty, are burdened with

exorbitant costs when they need health care.

A market failure in the private health insurance market points to the need for some sort of

public actor in the healthcare sector if we want to take steps forward in providing care for

all Americans. Along those lines is Barack Obama's plan to create a public pool for health

"insurance" . This proposal is an effort to create healthcare options for people who

wouldn't otherwise be able to afford it. However, mindful of the private market, Obama's

plan also has provisions to keep this plan price-competitive enough with the private

market to drive people into the public pool.

The nature of insurance and the private market are unavoidable features of America's

health care landscape. Attempts to understand and respond to these factors with clarity,

such as the Obama plan, are a good start to tackling health care reform in America.

http://www.google.com/url?sa=t&source=web&ct=res&cd=1&url=http%3A%2F%2Fcontent.healthaffairs.org%2Fcgi%2Fcontent%2Fabstract%2Fhlthaff.27.6.w533&ei=eMIYSYTaK4nOsAOp4KWKDA&usg=AFQjCNHbMZraeUPtyPY_gGptFjvGFT0Q0A&sig2=u-IYq6C0UqGuCpg6E5va7Q






Aims and objectives of study

I. To adapt, develop, plan and promote the study and dissemination of knowledge and

conduct research in the areas: Management, Bio-tech, Health, Infrastructure, Bankingand Insurance, Non-Governmental organizations, Environment, Community

Development and the areas relative there to.

II. To undertake projects and activities that may be necessary for the furtherance of the

above stated objectives.

III. To take up specific assignments, turn-key projects or any other form of

projects/contracts in the areas stated above using in-house resources or with the

participation of outside agencies.

IV. To initiate, establish and participate in collaborative educational, training,

consultancy and similar activities with other institutions/organizations within the

country and abroad.

V. To provide/undertake consultancy services for Public, Private, Governmental and

Non-Governmental organizations and International agencies and other bodies/institutions abroad on matters relating to the objectives of the Society.

VI. To maintain close contacts with other institutions/organizations having similar or

allied objectives by way of payment of subscription, enrollment as members thereof,fiscal or other sort of assistance, collaboration, cooperation and in any other manner as

the Society may deem it necessary.

VII. To establish educational institutions for the development of human faculties byimparting knowledge, skills for the advancement/enhancement of capabilities among

the youth of the nation by offering technical and non-technical courses that are of thefull-time, part-time and distance learning basis.

VIII. To innovate and develop appropriate international linkages and to establish off-campus centers for the furtherance of the objectives of the society.

IX. To conduct/organize teaching and training programmes, conferences, seminars,

lectures and similar other activities and award certificates, diplomas or accreditationsetc., in the areas under the objectives of the society and in other areas of societal

relevance

X. To institute and award fellowships, scholarships, prizes and medals in accordance

with rules determined by the KPR Educational Society.

XI. To engage in any other lawful activities as the society may deem fit or incidental

for the furtherance and attainment of its objectives.



Research Design

Design research investigates the process of designing in all its many fields. It is thus

related to Design methods in general or for particular disciplines. A primaryinterpretation of design research is that it is concerned with undertaking research into the

design process. Secondary interpretations would refer to undertaking research within the

process of design. The overall intention is to better understand and to improve the design process.

Sample Design

This report’s sample design is based on views of Doctors of ICICI Prudential Company.

Why ICICI Pru health saver needed ?

The Need

Increasing incidence of chronic ailments and lifestyle diseases results in a steady outflowof funds to meet medical expenses such as diagnostics, medicines and doctor visits which

are usually not covered by traditional health insurance plans. This becomes more

pronounced in old age, as very few individuals plan for it. Further, the increasing healthcover premiums at higher age groups are also a cause of concern.

Presenting ICICI Prudential’s Health Saver

A comprehensive health insurance and savings solution that not only provides your family with immediate hospitalisation cover but also aims to create a fund to keep you

prepared against any health related expenses especially allowing you to provide for rising

health care costs.

http://en.wikipedia.org/wiki/Design

http://en.wikipedia.org/wiki/Design_methods

http://en.wikipedia.org/wiki/Design

http://en.wikipedia.org/wiki/Design_methods



Health Saver

The Long Term Dual Benefit Tax Saving Health Plan

Hospitalisation Insurance Benefit Health Savings Benefit

Coverage against medical expenses

for inpatient hospitalisation and listed

day care procedures

Creates a health fund through

investment to meet all other healthcare

needs

With tax benefits under section 80D of the Income Tax Act of 1961

Health Savings Benefit – Meet your goal

• A part of your premiums are allocated for investment designed specifically to build a health fund to meet for health related expenses

• The health savings kitty is created by investment in a long term flexible savings

plan with multiple fund options and portfolio investment strategies based on your

preference.• Allows for health related claims from your savings kitty post 3 completed policy

years.

• Allows you to avail tax benefits u/s 80D for the entire amount invested.

How ICICI Pru Health saver works ?.

Step 1: Choose your annual limit

Select from a range of annual limits i.e. Rs 2 lacs , Rs 3 lacs , Rs 5 lacs , 7 Lacs and Rs

10 Lacs

Step 2: Choose your premium

While you have an option of selecting your premium you would require to follow the below minimum premium norms prescribed in the table below

• Age of eldest member

• No of Members• Annual Limit



Step 3: Choose your investment portfolio

Premium amount net of charges will be invested in your Health Savings Fund as per your chosen portfolio strategy. You can select between the following two strategies:

• Lifecycle based portfolio strategy

• Fixed Portfolio strategy

Features and Benefits of hospitalization

This benefit in your policy provides you cover against medical expenses that require a

minimum of 24 hours hospitalisation. In addition, over 125 day-care procedures are also

covered.

The following expenses incurred during hospitalisation are covered, subject to your

annual limit:

1. Room, Boarding and Nursing expenses as charged by the hospital where the

insured availed medical treatment. You are entitled to a single A/C room (roomrent capped at 1% of annual limit per day). However for twin share A/C room

there is no such cap applicable.

2. Intensive Care Unit (ICU) charges

3. Fees for Doctor, Surgeon, Anaesthetist, Medical Practitioner, Consultant and

Specialist

4. Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical appliances,

Medicines and Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy,

Radiotherapy, Cost of Pacemaker, Cost of Artificial Limbs*

Minimum Premium

Individual Family floater

Age of the eldest

member (in years)

All annual

limits

Annual limits

upto Rs. 5 lacs

Annual limits

greater than Rs. 5

lacs

Less than 40 10,000 15,000 20,000

40 - 55 15,000 25,000 30,000



Other Features of this Benefit

Feature Description

Family floater

With the family floater option, you can additionally cover

your spouse and up to the first three dependant children

under the same annual limit.

Daycare

Treatement

Cover

In addition to hospitalisation, you are also covered for procedures which require less than 24 hours of

hospitalisation. These include over 125 listed day care

surgeries, Parenteral Chemotherapy, Radiotherapy,

Intervention Cardiology, Intervention Radiology, Radiofrequency Ablation Treatment, Lithotripsy and Dialysis.

Pre & Post

Hospitalisation

Cover

Pre hospitalisation expenses up to 30 days prior tohospitalisation and post hospitalisation expenses up to 60

days from the date of discharge are also covered. The pre

and post hospitalisation expenses would be covered only incase the expenses incurred are related to the main

hospitalisation event.

Medical check

ups

A free health checkup will be available to all insured

members after the first year once every 2 years. Each

member can submit only a single bill in every block of 2years after the first year. The bills of any one member

cannot be aggregated. The cumulative limit for all the

members under the policy would be 1% of the annual limitor Rs 5000 whichever is lower. Please contact our call

center for further details

Ambulance

charges

Up to Rs. 1,000 per policy year subject to acceptance of

main hospitalisation claim.

No Claim Bonus A no claim bonus in the form of an increase in annual limit by 5% of the base annual limit is provided for every claim

free year. The maximum increase over the base annual

limit will be capped at 25%. In case of a claim, the



accumulated no claim bonus will reduce by 10% of the

base annual limit in the following year. In no circumstance

will this reduction cause the annual limit to go below the base annual limit.

Cashless

Network Access

You have an access to an extensive network of hospitalson a cashless basis.

Out of network

claims

A co-pay of 20% on the eligible medical expenses will beapplicable in case you either

- Stay in single A/c room with a room rent of more than

1% of your annual limit- Access facilities at hospitals not listed in the chosen

network

What happens in an emergency?

In case of emergency hospitalisation related to cardiac and

trauma cases, co-pays will not be levied even whenhospital is outside your chosen network as long as benefit

availed is in a twin sharing room.

CLAIM PROCESS

With ICICI Prudential’s Health Saver policy, you can now plan ahead, be in control inany medical eventuality and focus on getting better without having to worry about the

money. ICICI Prudential provides a seamless and hassle-free claims experience with

Health Saver.

To ensure faster processing and settlement of claims, please adhere to the following:

Complete disclosure

Make sure that all the information related to your health is given to the company as thiswould ensure faster settlement of claims and avoid disappointments later. Please refer to

the copy of your application form in the welcome kit to check the disclosure made by

you.

Claims intimation and processing



You have to provide complete and accurate information asked by the company at the

earliest to ensure faster claim settlement. Please refer to the policy document for details.

Why ICICI mediassure is needed ?

Health problems, in most cases, strike us unexpectedly, resulting in a sudden financial

burden. Despite this, only around one in every fifty Indians, is covered through someform of individual medical insurance. Further, it has been observed that 2 out of every 5

individuals hospitalised in India end up either borrowing money or selling assets to cover

healthcare costs. This situation is set to escalate further as private health care spends in

India are estimated to increase by 2 to 3 times over the next 12 years.

Hence you need a solution that gives you peace of mind by providing financial cover to

both you and your family against unforeseen hospitalisation events.

So what should you look for when buying a medical/hospitalisation cover:

• Does the plan guarantee you insurability at renewal irrespective of your healthstatus?

• Does the plan ensure that no new exclusions are added or no increase in premiums

occurs just because a claim is made?

•

Does the plan clearly state exclusions at the time of taking the policy and alsooffer you cover against pre-existing conditions?

ICICI Prudential Life Insurance presents MediAssure, a health insurance plan with aAAA guarantee for the family

• Assured cover till age 75 years

• Assured coverage for accepted pre-existing illnesses after 2 years

• Assured price for 3 years

Features and Benefits

Key Benefits of the MediAssure policy

• Hospitalisation coverage for your family under a single policy

• Pre-existing illnesses & conditions covered subject to underwriting

• Guaranteed insurability up to 75 years of age

• Coverage for Pre & Post-Hospitalisation expenses



• Over 125 day care procedures covered

• No claim bonus of 5% of annual limit for every claim free policy year

• Cashless Hospitalisation in our extensive network of hospitals across the country

• Flexibility in upgrading hospital room facilities with additional co-pay

• Avail tax benefits on premium paid u/s section 80D of IT Act, 1961

Benefits in detail

1.FamilyFloater

With the family floater option, you can additionally cover your spouse and up to the first

three dependent children to the same annual aggregate limit.

2.Guaranteed insurability up to 75 years of age

You can renew the policy once and within 30 days from the termination date with the

same terms and conditions. You can further renew the cover under the then offered ICICI

Pru MediAssure product or its nearest substitute within 30 days from the policy

termination date. The outstanding waiting period from the current policy will be appliedon continuation of cover. Your premium payable on renewal and on subsequent

continuation of cover shall be reviewed subject to IRDA approval.

3.Pre exiting illnesses covered

Pre existing illnesses and conditions which are declared at inception and specificallyaccepted by the company would be covered under this policy. For conditions of diabetes

or hypertension which are disclosed at inception and which are accepted for cover, any

complications arising from these conditions will be covered after the first two

consecutive policy years.

4.Pre-Hospitalisation and Post Hospitalisation CoverPre-Hospitalisation expenses up to 30 days prior to hospitalisation and post-hospitalisation expenses up to 60 days from the date of discharge are also covered. The

Pre and Post Hospitalisation expenses would be covered only in case the expenses

incurred are due to the main hospitalisation event.

5.Day Care Treatment Cover

In addition to hospitalisation, you are also covered for procedures which require less than24 hours of hospitalisation. These include over 125 listed day care surgeries, Parenteral

Chemotherapy, Radiotherapy, Intervention Cardiology, Intervention Radiology, Radio

frequency Ablation Treatment, Lithotripsy and Dialysis.

6.No Claim Bonus

You are entitled to a 5% increase in your annual limit for every claim free year subject to

a maximum of 25% increase in the annual limit. Incase a claim is made during a policyyear; the bonus amount would revert to 0% in the following year.



How does mediassure works?

What does MediAssure cover?

The policy provides you cover against inpatient hospitalisation, procedures and surgical

expenses that require a minimum of 24 hours hospitalisation. In addition, over 125 day-

care procedures are also covered.The following expenses incurred during hospitalisation are covered, subject to your

annual limit:

a. Room, Boarding and Nursing Expenses as charged by the hospital where the Insuredavailed medical treatment

b. Intensive Care Unit (ICU) charges

c. Fees for Doctor, Surgeon, Anaesthetist, Medical Practitioner, Consultant and Specialistd. Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Consumables,

Medicines and Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy,

Radiotherapy, Cost of Pacemaker, Cost of Artificial Limbse. Pre and Post hospitalisation expenses related to the hospitalisation

Please note:

Payout for Doctors’ fees (including surgeon, anaesthetist) will be limited to 30% of

eligible claim amount for inpatient claims.Payout for artificial limbs would be limited to lower of Rs 25,000 or 10% of the Annual

Limit.

How does my plan work?

Choosing your plan is very simple

Step 1: Set your Annual Limit

The Annual Limit is the maximum benefit payable under the policy towards all the

eligible medical expenses described above and incurred during a policy year. You canselect between various Annual Limit options i.e. Rs 2 Lacs, Rs 3 Lacs, Rs 5 Lacs, Rs 7

Lacs or Rs 10 Lacs.

Step 2: Select your Network You can choose between the Premium and Classic plans. The Premium plan gives you

access to all List A and List B hospitals across India. The Classic plan gives you access to



all List A hospitals across India along with limited access to List B hospitals as shown in

the table below.

Plan Type

Eligible

Room TypePremium Classic

Upto Single

A/C room

List A hospitals all

over IndiaList A hospitals all over India

Upto Twin

A/C room

All List B hospitals

all over India

All List B hospitals all over India exceptdistricts of Mumbai, Navi Mumbai and

Thane

Please Note: The Hospitals which are included in List A and List B will be available with

your policy kit and also on this website in the Downloads section

What happens when I access out of network facilities?

A co-pay of 20% on the eligible medical expenses will be applicable in case you either

• Upgrade to a higher room type in the network hospitals, eg, a single A/C room at List B

hospital, or,• Access facilities at hospitals not listed in the chosen network, eg, if you have chosen the

Classic plan and access care at a List B Mumbai hospital, or, if you access care at a

hospital not given in List A or B.

Please Note: Co-pay is that percentage of the total eligible medical expenses that is borne

by you while the balance is settled by the Company

What happens in an emergency?

In case of emergency hospitalisation related to cardiac or trauma cases, co-pay will not belevied even when the hospital is outside your chosen network. However your room

eligibility in such a case will be to the extent of twin-share A/C room only.



Why Hospital Care ?

The need

Today, when you are young and healthy, planning for a contingency is not always a

priority but the cost of treating even the smallest of ailments is on the rise. You realize it

only when you or your loved ones has to undergo some medical emergency and you arefaced with the challenge of organizing funds to meet the hospitalisation related expenses.

Hence a medical emergency comes not only with emotional turmoil but also with a hugeexpense attached to it.

During such an unexpected situation, your only concern should be that the best doctors

and medical facilities are available and cost should not be a constraint so that you can

take care of things without compromise but to ensure that best in class treatment is provided, the key to that is to be financially prepared for it.

To help you manage this unexpected emergency, ICICI Prudential presents Hospital Care- a comprehensive insurance policy that has:

• Facility of cashless hospitalisation in an extensive network of hospitals in India

• Benefit amount will be paid in addition to payment received by you from other medical insurance plans.

• You will receive lump-sum benefit amount, irrespective of the actual billing.

• Long term guaranteed coverage up to 20 years.

• Tax benefits on premium paid up to Rs.15,000 under Section 80D.



Features of Hospital Care

1. Hospitalisation Benefits (DHCB)

• Get a benefit amount if you are hospitalized for more than 24 hours i.e. at least 2

consecutive nights and must be charged for 2 days room expenses.

•

The benefit amount is fixed and will be paid irrespective of actual hospitalisationexpenses

• DHCB is payable for hospitalisation up to 90 days per policy year, which

includes any days spent in Intensive Care Unit.

2. Intensive Care Unit (ICU) benefit

• An additional 50% of DHCB amount per day is paid to you if you get admitted to

an Intensive Care Unit (ICU), and this amount is paid depending on the plan

chosen.• The ICU benefit is payable for hospitalisation up to 30 days per policy year, and

is paid in addition to DHCB.

3. Recuperating benefit

• A post-hospitalisation benefit amount in addition to all other amounts will be paid

out to ensure that follow-up tests, medicines and consultations go ahead as planned .

•

You are eligible for recuperating benefit only on being hospitalized continuouslyfor 5 or more days DHCB.

4. Surgery benefit



Over and above the hospitalisation expenses, a fixed lump-sum amount is also paid for

more than 900 surgical procedures. These surgeries have been classified into four grades,

depending on the type and severity. A sample list of surgeries is given below:

Grades Surgeries

1 Tennis elbow release, bladder stone removal

2 Hernia, Removal of uterus

3 Removal of kidney, removal of thyroid gland

4 Open heart surgery, removal of brain tunour

5. Benefit amounts at-a-glance

You can choose any one plan, from the following four options Each plan has fixed

benefit amounts, as shown below:

BenefitPlan A

(Rs.)

Plan B

(Rs.)

Plan C

(Rs.)

Plan D

(Rs.)

Daily Hospitalistion Cash

Benefit (per day)1,000 2,000 3,000 4,000

ICU (Intensive Care Unit)Benefit per day)

500 1,000 1,500 2,000

Recuperating Benefit 3,000 6,000 9,000 12,000

Surgery Benefit

Surgery grade 1 15,000 30,000 45,000 60,000

Surgery grade 2 50,000 1,00,000 1,50,000 3,00,000Surgery grade 3 75,000 1,50,000 2,25,000 4,00,000

Surgery grade 4 1,00,000 2,00,000 3,00,000 4,00,000

Waiting period – 90 days except accidental claims.

Sample Case 1

In case you opt for plan A, then for an 8-day hospitalisation, your benefit amountis

DHCB = 8 days * Rs. 1,000 per day = Rs. 8,000

+

Recuperating Benefit = Rs. 3,000

(refer to the table below for benefit amounts)

Total benefit amount = Rs. 11,000

Sample Case 2

In case you opt for plan D, then for an 6-day hospitalisation, including 4 days in



ICU, with a Grade 2 surgery, your benefit amount is

DHCB = 6 days * Rs. 4,000 per day = Rs. 24,000

+

4-day ICU benefit = 4 days * Rs. 2,000 per day = Rs. 8,000

++

Grade 2 Surgery benefit = Rs. 2,00,000

(refer to the table below for benefit amounts)

Total benefit amount = Rs. 2,44,000

6. High benefit limits

Hospital Care policy offers you high benefit limits. For instance,under plan A, you can

claim up to Rs.4 lakhs for multiple claims, including surgical benefit up to Rs.3 lakhs

annually. However, for the entire policy term, you can make multiple claims up to Rs.20lakhs.

Benefit LimitsPlan A

(Rs.)

Plan B

(Rs.)

Plan C

(Rs.)Plan D (Rs.)

Yearly Limit 4,00,000 8,00,000 12,00,000 16,00,000

Surgical benefit 3,00,000 6,00,000 9,00,000

Policy Term

Limit20,00,000 40,00,000 60,00,000 80,00,000

Benefits of Hospital Care

Payout in addition to other plans

You can claim benefit amount from this policy as well as any other medical insurance

policy you may have, since the company only requires submission of photocopies or

duplicates of bills and certificates. The lump-sum benefit amount will be paid to you,irrespective of your actual medical expenses.

Cashless hospitalisation

You don't need to make any payment upfront. We shall pay the billed amount upto the

benefit payable under the product, directly to the hospital, as settlement of your dues.This facility is available through our extensive list of network hospitals across the

country. Click here for the list of network hospitals.

Multiple claims

http://www.iciciprulife.com/public/docs/hospital_list_4th_may_2009.xls

http://www.iciciprulife.com/public/docs/hospital_list_4th_may_2009.xls



Life being uncertain, you may incur medical treatment costs several times. You can make

multiple claims during the policy term, so long as the total amount payable does notexceed the benefit limit you are entitled to.

Transparent coverage norms

This policy is very transparent and informs you upfront about benefit payouts, the

coverage and exclusions. This helps you plan your finances in the event of an emergency,so that you can concentrate on the treatment.

Guaranteed coverage

Medical eventualities can occur at any time. This policy guarantees you coverage for the

entire policy term, so that you enjoy the benefit of the cover, irrespective of any claims

made or a change in your health status during the policy term.

Tax benefit

The premium paid by you up to Rs.15,000 p.a. is eligible for tax benefit under Section 80

D, as per prevailing Income Tax laws .

General Exclusions

1. No benefits shall be payable with respect to any period of Hospital

Confinement/ICU stay unless the entire confinement / ICU stay and all the

Hospital services rendered and performed there had been recommended by a physician and are in accordance with the diagnosis and treatment of the condition

for which hospitilisation was required.

2. No benefits shall be paid for the following services, products and conditions:

pre-existing illness unless stated in the proposal form and specifically accepted by the

ompany and endorsed thereon;

1. hospitalisation and / or treatment within the Waiting Period (as stated in clause 6);

2. eye tests, refractive errors of the eyes, refractive surgery;3. any dental surgery, extraction of impacted tooth / teeth, orthodontics or

orthographic surgery, or Temporo-Mandibular Joint Disorder except as

necessitated by an accidental injury;4. treatment arising from pregnancy which shall include childbirth, infertility,

erectile dysfunction or impotency, miscarriage, abortion, sterilization and

contraception including any complications relating thereto;

5. treatment for congenital conditions including physical defects present from birth;6. hospitalisation primarily for investigatory purpose, diagnosis, X-ray examination,

general physical or routine medical examination; preventive treatments /



medicines, treatments / examinations specifically for weight reduction or gain

regardless of whether the same is caused (directly or indirectly) by a medical

condition; convalescence, custodial, sanitaria, rehabilitation centre, nature cureclinics or rest care and similar establishments; or private nursing.

7. treatment arising from any geriatric, psycho-geriatric or psychiatric condition,

insanity, mental or nervous breakdown or "rest cures";8. treatment directly or indirectly arising from alcoholism or drug abuse and any

injury or sickness which the Life Assured may suffer after he has taken

intoxicating liquors or drugs;9. 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

full- time service in any of the armed forces;

10. Acquired Immune Deficiency Syndrome (AIDS) and all illnesses or diseasescaused by or related to the Human Immuno-deficiency Virus (HIV);

11. sexually transmitted diseases (STD);12. cosmetic or plastic surgery except to the extent that such surgery is necessary for

the repair of damage caused solely by Accidental Injuries, treatment of

xanthelesema, syringoma, acne and alopecia;

13. study and treatment of sleep apnoea;14. deliberate exposure to exceptional danger (except in an attempt to save human

life);

15. nuclear disaster, radioactive contamination and/or release of nuclear or atomicenergy; and injuries arising out of or in connection with:

16. military duties of a peace-time nature, namely normal training range work and

military exercises;17. treatment for injury or illness caused by intentionally self-inflicted injuries; or any

attempts at suicide while sane or insane;

18. treatment for injury or illness caused by violation or attempted violation of thelaw or resistance to arrest;

19. treatment for injury or illness caused by professional sports, racing of any kind,

scuba diving, aerial sports, activities such as hand-gliding, ballooning, and any

other hazardous activities or sports unless agreed by special endorsement;20. All organ transplant where the Life Assured acts as a donor and all expenses

incurred by the donor for such organ transplant;

21. Circumcision unless necessary for treatment of a diseases or necessitated due toan accident;

22. Diagnosis and treatment outside India. However, this exclusion shall not be

applicable in the following countries: Australia, Brunei, Canada, Dubai, HongKong, 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 only acceptable in English language unless specifically

agreed otherwise, and dully authenticated

23. Failure to seek or follow reasonable medical advice.24. Ayurvedic, Homeopathy, Unani, naturopathy, reflexology, acupuncture, bone-

setting, herbalist treatment, hypnotism, rolfing, massage therapy, aroma therapy

or any other treatments other than Allopathy /western medicines.25. Hospitilisation and treatment of any kind not actually performed, necessary or

reasonable, or any kind of elective surgery or treatment which is not medically

necessary or any surgical procedure not performed in a hospital.

THE GUIDE TO EASY CLAIMS WITH HOSPITAL CARE

The claims can be under two scenarios:

- Planned Hospitalisation- Emergency Hospitalisation

It can either be in a 'Network Hospital' or in 'Non-Network Hospital' depending on theneed and location of the claim.

THE CLAIMS PROCESS

On issuance of the policy, as part of the Welcome Kit, you will receive the following:

1. Health Card (a card which has your policy number and contact information of

ICICI Prudential and it can be utilized only in Network Hospitals)2. Claims and Pre-Authorization Forms

When there is a need for hospitalization, you can inform ICICI Prudential abouthospitalisation by calling on the contact number provided on the health card. You need to

provide following information when you call ICICI Prudential about the claim

• Your Policy Number (as mentioned on the health card)

• Name of insured person who is hospitalized.

• Nature & Details (location, date of accident or commencement of sickness)

• Name & Address of Hospital, where life insured is admitted

All the above information can be provided to ICICI Prudential immediately or prior to

availing treatment and in any case within 4 days of hospitalization in case of a network

hospital.

24*7 ClaimCare Cell: 1800-103-6363



Photocopies or duplicates of the following documents will be needed to process the

claim:

1. Copy of policy certificate2. Claimant's Statement form

3. Duly filled claim form (provided along with the welcome kit or available on our website)

4. Treating Doctor's Certificate

5. Copy of Indoor Case Papers6. Hospital Discharge Card/Summary

7. Medical evidence in form of diagnostic reports, prescriptions, bills with breakup,

any other document to support hospitalization / surgery.

Besides the above, if required, ICICI Prudential may request for additional documents /information, if any, for processing the claim.

1. CASHLESS Hospitalisation in a NETWORK HOSPITALS

a. PLANNED HOSPITALISATION

Step 1: Call and inform ICICI Prudential (on the help line number provided on the

reverse of the health card) about the planned hospitalization 4 days prior to the treatment, before admitting into the hospital.

Step 2: Download the pre-authorization form from or you could even visit any of our branches.Step 3: To gain access to the network hospitals, just show your health card and also

submit a duly filled pre-authorization form at the treating hospital.

Step 4: The forms shall be scrutinized and further processed and the cashless facility will be activated. We will inform you about the cashless facility being activated through SMS.

Also the status of the case will be updated on the website.

Step 5: On discharge, you need to sign the required documents at the hospital.Step 6: ICICI Prudential will pay the amount to hospital.

b. EMERGENCY HOSPITALISATION

Step 1: In case of emergency, first admit the patient in the Hospital and then informICICI Prudential, within 24 hours. You can call up on the number provided on the reverse

of the health card.

Step 2: As it's an emergency, you have the facility of collecting the pre-authorizationform from the treating hospital or you could even download the pdf format from the

website.

Step 3: Show your health card to the network hospital and also submit the pre-authorization form to the treating hospital.



Step 4: The forms shall be scrutinized and further processed and the cashless facility will

be

Step 5: On discharge, you need to sign the required documents.Step 6: ICICI Prudential will pay the hospital.

The Cashless Settlement Scenario:

• Hospital bill amount is more than your eligible amount: ICICI prudential settles

the eligible amount with the hospital and balance bill amount is payable by you.• Hospital bill is less than eligible amount: ICICI Prudential settles the claim with

the hospital and the balance eligible amount is paid to you

2. HOW TO CLAIM IN CASE OF HOSPITALISATION IN NON-NETWORK HOSPITALS

While it's suggested that you choose a network hospital, you are at liberty to choose a

Non-network hospital also. In case you avail treatment in a non-network hospital, ICICI

Prudential will pay you the eligible amount as per the plan opted by you.Step 1: Get admitted to the hospital and take the complete treatment.

Step 2: Settle the relevant bills in full, on discharge.

Step 3: Collect all the treatment papers along with the doctor's prescriptions, investigation

reports, Hospital Discharge card, photocopies or duplicates of medical bills and receipt of hospital Bills and copy of FIR (if any, in case of an accident).

Step 4: Lodge your claim by filling in the claim form (you can collect the claims formsyour nearest ICICI Prudential branch or the website.) and attach all the requireddocuments, within 60 days from the date of discharge.

The claim will be processed within 7 working days from the date of receiving all therequired documents.

Why Crisis Cover ?

Life is hectic in today's fast paced world. Along with the rapid pace and progress comes

the bane of modern life such as increased stress, poor diet and lack of exercise. Thealarming aspect is that, owing to these factors, more and more Indians are becoming

vulnerable to critical illnesses every year. These illnesses, coupled with increasing costs

of treatment, have made recovery a long and expensive process.

It goes without saying that securing your family's financial future is a part of prudent

financial planning. However, no less important is your health and well-being, for which



you need a comprehensive health coverage. And, given our lifestyles, it should ideally be

a plan that provides complete protection against Disease, Disability and Death.

Keeping this need in mind, ICICI Prudential Life Insurance presents Crisis Cover. This

all-inclusive long term insurance policy provides coverage against 35 critical illnesses,

total and permanent disability, and also death.

So, get the right protection tailored to suit your lifestyle, with this plan which is

•Comprehensive

•Affordable

• Long Term

Key benefits of Crisis Cover

• Benefit amount paid on diagnosis of any of the 35 diseases (critical Illnesses),

disability or death

• Receive lump-sum benefit amount irrespective of actual billing

• Benefit amount will be paid in addition to payment received by you from other

medical insurance plan

• Long term coverage upto 75 years of age

• Coverage continues even after claiming benefit on select critical illness

• Premium paid is eligible for deduction under section 80C & section 80D*



• The overall limit of deduction for investment u/s 80C & u/s 80D of the Income

Tax Act, 1961 are Rs. 1,00,000 & Rs. 15,000 respectively, subject to conditions

mentioned therein.

How does Crisis Cover work?

1. Choose a Sum Assured under Crisis Cover

2. Pay Premium based on your age and sum assured and term of cover chosen3. Get the applicable sum assured in the event of being diagnosed with a critical

illness or on being rendered totally disabled or on death, whichever occurs first.

4. Remain covered even after a claim on select Critical Illnesses

Get the Sum Assured on under the plan on first occurrence of Death or Total

Permanent Disability or on diagnosis of any one of the following 35 Critical illnesses.

Flexible Payouts for the 35 Critical Illnesses covered

Flexible payouts for 35 Critical Illnesses covered are as below:

CI with Full Payout AdvantageCI with Coverage Continuation

Advantage

• Apallic Syndrome

• Benign Brain Tumour

• Blindness

• Brain Surgery• Cancer

• Chronic Lung Disease

• Coma

• Coronary Artery Bypass

surgery

• End stage liver disease

• Heart Attack

• Heart Valve Surgery

• Kidney Failure

• Loss of Independent

existence• Loss of Limbs

• Major Burns

• Major Head Trauma

• Major Organ Transplant

• Paralysis

• Stroke

• Angioplasty*

• Alzheimer's Disease

• Aplastic Anaemia

• Cardiomyopathy• Deafness

• Loss of Speech

• Medullary Cystic Disease

• Motor Neurone Disease

• Multiple Sclerosis

• Muscular Dystrophy

• Parkinson’s Disease

• Poliomyelitis

• Primary Pulmonary hypertension

• SLE with Lupus Nephritis



• Surgery to aorta

• Terminal Illness

The Critical Illnesses with Full Payout Advantage : Get the full benefit amount for Critical Illnesses covered under this category. The benefit amount payable is equal to the

full sum assured chosen under the policy.

The Critical Illnesses with Coverage Continuation Advantage : The maximum benefit

amount payable is Rs. 500,000* for Angioplasty and Rs. 1,000,000 for all other critical

illnesses in this category and the cover continues for all other remaining illnesses benefitsfor the remaining sum assured chosen under the policy.The premium is also revised

proportionately on the following Policy anniversary for the reduced Sum Assured.

* 50% of sum assured with a max limit of Rs. 500,000

Death or Total & Permanent Disability

The Full Sum Assured as chosen under the plan is paid in the event of Death or Total

Permanent Disability of the Life Assured. This benefit is payable even if death or disability occurs because of an accident.

Claims Process made simple

Our claims process is an easy 3-step process. This will ensure that you get a hassle-free

and convenient claims experience.

1. Submit a written notice along with the proof of diagnosis of the critical illness /

disability / death required for claim.

2. The company verifies the documents and admits the claim.3. The company pays the entire benefit amount as applicable

Why Cancer Cover ?

As someone who has seen family members and friends struggle to survive Cancer, youhave undoubtedly suffered yourself. You know the extent to which the illness drains the

family; that the loss is both emotional, and financial.



You would have also read, time and again, articles where medical experts unanimously

agree that Cancer can attack anyone, anywhere, at any time. But this truth is only one part

of the whole picture. Doctors also verify that those with a family history of Cancer areespecially prone to being affected by it.

Given all these important facts, have you stopped for a moment and asked yourself,"Why have I not insured myself against Cancer?"

ICICI Prudential suggests you insure yourself, right away, with Cancer Care-acomprehensive Cancer insurance policy, which enables you and your family to stay

financially and mentally secure should you be diagnosed with early or advanced Cancer.

Read more about the features and benefits of this plan that provides you with a SumAssured of up to Rs. 25 lakhs.

Types of Cancer covered by cancer cover

Cancer Care covers most forms of early and advanced stages of cancer that affects bothmen and women. Following are the most common cancers that are covered under Cancer

care:

Cancers that commonly affects women:

• Breast Cancer

• Cancer of Cervix

• Ovary Cancer

• Oesophagus Cancer

• Lung Cancer

Cancers that commonly affects men:

• Lung Cancer

• Oesophagus Cancer

• Larynx

• Stomach Cancer

• Hypolarynx Cancer

• Prostrate Cancer



Early cancers that affect men and women:

•

Hodgkin’s Disease Chronic Lymphocitic Leukemia• Chronic Lymphocitic Leukemia

• Cancer of Colon or Rectum• Cancer of Urinary Bladder

• Cancer of the stomach, large bowel, bladder, head and neck, liver, pancreas, gall

bladder, brain, kidney, lymphoma, leukemia, thyroid, and skin. These cancers alsoaffect men and women at an advanced stage.

Benefits and features of cancer cover

Comprehensive cancer insurance plan: Get covered for most forms of cancer. Unique

design: Receive pay benefits at both early and advanced stages.

Cash payouts: Meet your expenses at for diagnosis, treatment and surgery, with cash

payouts at various stages.

Sum Assured up to Rs. 10 lakhs: Receive this amount for a premium as low as Rs. 250

a month.

Benefits accrued: The benefits accrued if you purchase 10 units (equivalent to Rs. 10

lakhs) of Cancer Care are enumerated in the table below:

If an early Cancer claim has been made

If no early Cancer claim has been made

Diagnosis of Early Cancer* Rs. 1 lakh NA

Oncological Treatment

Benefit for Early Cancer Rs. 1 lakh NA

Diagnosis of AdvancedCancer

Rs. 5.5 lakh Rs. 6.5 lakh

Oncological Treatment

Benefit for Advanced Cancer Rs. 1 lakh Rs. 1.5 lakh

Surgery for Advanced Cancer Rs. 1.5 lakh Rs. 2 lakh

Maximum Cover Rs. 10 lakh Rs. 10 lakh

No medical bills required: Enjoy a hassle-free claim procedure. Receive the benefit

amount without showing any medical bills.

No medical examinations: Enjoy a waiver on medical examinations if you purchase up

to 15 units (equivalent to Rs. 15 lakhs).



Waiver of premium: Have your premiums waived if diagnosed with advanced Cancer.

Tax benefits:Enjoy tax benefits on the premiums you pay (under u/s 80 D).

Why ICICI Pru Diabetes Care Active ?

According to the WHO, India is the diabetes capital of the world, with more than 20%

of the diabetes cases. The main causes are our sedentary lifestyle, poor eating habits and

genetic pre disposition. India also has a high prevalence of people with Impaired GlucoseTolerance (IGT) or Impaired Fasting Glucose (IFG), pre-diabetic conditions, which lead

to diabetes if not managed early. Moreover, there is an increasing trend of onset of these

conditions at younger ages in India.

For the many diabetics, the above translates into an altered lifestyle characterized by

change in food habits, physical activity & medication. It also brings along many serioushealth complications such as heart attack, kidney failure & stroke, which may entail a

huge financial burden.

On the other hand, regular monitoring, life style changes, medication and diet control,can lead to a healthy life and postpone or possibly even avoid the complications.

Keeping in mind the above, ICICI Prudential proudly presents ICICI Pru Diabetes Care

Active. This offering aims to provide you a comprehensive diabetes managementsolution. While our Wellness Programme ensures that you stay healthy, our insurance

guarantees financial assistance in case a critical illness does strikes. The plan aims toencourage, enable & offer you incentives to manage your diabetes by reducing premiums

for good diabetes management.



Key Benefits of ICICI Pru Diabetes Care Active

• Wellness Programme to help you manage diabetes avoid complicationso Regular medical testing and annual doctor consultation

o Diabetes Coach to facilitate diabetes management

o Special offers from our healthcare partners

o Support through online tools

• Reduced premiums upto 20% on showing good control over your diabetes

• Lump-sum amount paid on diagnosis of 7 critical illnesses including Angioplasty• Long term coverage upto 65 years of age

• Tax benefits under section 80D of the Income Tax Act, 1961

Features and Benefits of ICICI Pru diabetes Care active

Managing your Diabetes is the key to staying healthy

To enable you to regularly monitor your health and take necessary care, the policy provides for a wellness programme, under which, you have to undergo checkups as per a

defined protocol every six months. This protocol is described below and would be

applicable in each policy year.

• 6th month of every policy year: HbA1c test, blood pressure and pulse

• 12th month (except in the last policy year*): HbA1c, lipid profile, blood pressure,

pulse rate and a doctor consultation

* The annual check-up would however not be provided for in the last policy year as it

would coincide with the end of the policy term.

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Wellness.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Coach.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Support.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Reducing.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Financial.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Tax.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Wellness.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Coach.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Support.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Reducing.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Financial.htm

http://www.iciciprulife.com/public/Health-plans/DiabetesCareActive_Tax.htm



Claim Process

Our claims process is an easy 3 step process. This will ensure that you get a hassle-freeand convenient claims experience.

1. Submit a written notive along with proof of diagnosis of criticall illness/ surgery,

required for the claim.2. The company verifies the documents and admits the claim.

3. The company pays the entire benefit amount as applicable.



What does ICICI Pru Diabetes

Care Active cover

What does ICICI Pru Diabetes Care

Active not cover

Financial Cover

• Lumpsum paid on diagnosis of

7 Critical Illnesses i.e. HeartAttack, Stroke, Bypass

Surgery, Major Organ

Transplant (as recipient), End

Stage Renal Failure, Cancer,and Angioplasty. (Please refer

to finacial support section for

detailed description)

Financial Cover

• The policyholder needs to

survive beyond 10 days of diagnosis of Critical Illness

(CI) to be eligible for a claim

payout

Diagnosis & Testing

Wellness ProgrammeRegular free testing (HbA1c, Blood

Pressure, and pulse rate test) on every

6th month/year during the policy term.

• An annual comprehensivemedical checkup will be

provided at the end of the each

policy year (except in last

policy year).• One free consultation with an

expert physician every year.

• Test results will be availableon the diabetes care website

Diagnosis & Testing

• Test results from diagnostic

centers or doctors who are notfrom our empanelled network

will not be accepted / will not

be reimbursed.

• Any additional consultation or

tests conducted will not be

covered or reimbursed under

the plan.

• No payment / benefit will be

available against tests not done.



Advantages of ICICI Pru Hospital Care

Payout in addition to other plans

Cashless hospitalisation

Multiple claims

Transparent coverage norms

Guaranteed coverage

Tax benefit*



Benefit amounts of ICICI Prudential

Hospital CareBenefit Plan A (Rs.)

Daily Hospitalisation Cash Benefit (per day) 1,000

ICU (Intensive Care Unit) Benefit per day) 500

Recuperating Benefit 3,000

Surgery Benefit

Surgery grade 1: Tennis elbow release, bladder stone removal 15,000

Surgery grade 2: Hernia, Removal of uterus 50,000

Surgery grade 3: Removal of kidney, removal of thyroid gland 75,000

Surgery grade 4: Open heart surgery, removal of brain tumor 1,00,000

Benefit limits

Hospital Care policy offers you high benefit limits. For instance, under plan A, you can claim up toRs.4 lacs for multiple claims, including surgical benefit up to Rs.3 lacs annually. However, for the

entire policy term, you can make multiple claims up to Rs.20 lacs.

Benefit Limits Plan A (Rs.)

Yearly Limit 4,00,000

Surgical benefit 3,00,000

Policy Term Limit (upto 20 years) 20,00,000

Typical Example

In case you opt for plan A, then for an 8-day hospitalisation,your benefit amount is

8 days * Rs. 1,000 per day = Rs. 8,000

+

Recuperating Benefit = Rs. 3,000

Total benefit amount = Rs. 11,000



Claim Process of ICICI Prudential Hospital Care Policy

When there is a need for hospitalization, you can inform ICICI Prudential abouthospitalization by calling on the contact number provided on your health card.

You need to provide following information.

Your Policy Number (as mentioned on the health card)

Name of insured person who is hospitalized.

Nature & Details (location, date of accident or commencement of sickness)

Name & Address of Hospital, where life insured is admitted

Photocopies or duplicates of the following documents will be neededto process the claim

Copy of policy certificate

Claimant's Statement form

Duly filled claim form (provided along with the welcome kit or available on our website)

Treating Doctor's Certificate

Copy of Indoor Case Papers

Hospital Discharge Card/Summary

Medical evidence in form of diagnostic reports, prescriptions, bills with breakup,any other document to support hospitalization / surgery.

QUESTIONAIRE



1. How is our products performance ?

2. Our which product sold more by you ?

3. What is the reason of more sale of that product ?

4. What kind of products demanding more by customers ?

5. How much our products you sells in a month ?

6. Are you satisfied with our company or not ? (If No, why)

7. Which type of customers likes our products more ? (Age or group)

8. Are you receiving the regular payout from our company ?

9. How can we increase the sales of our products ? (Suggestions)

.

.

.

10. Are you selling the other companies products also ?

11. How much products of other companies you are selling in a months ?.

(Munish Kumar)

LEVEL OF SATISFACTION OF DOCTOR,S AND PATIENTS



According to the survey of Doctors and patients, it is found that the patients

and doctors (ICICI Prudential) are satisfied more than other company products andservices. The result of survey later done ensures the positive attitude of Doctors and

patients towards company Products and performance therefore the company making the

new mile stones in the sector of life insurance policy and stand in the way of beingmarket Pioneer .

INDEX, ANALYSIS & INTERPRETATION

AND CONCLUSION WILL BE MADE.

Documents

Munish ICICI Report