ICICI Lombard Elevate Health Insurance Guide 2026

Summary: ICICI Lombard Elevate is an indemnity health insurance policy issued by ICICI Lombard General Insurance Company Limited. The current official policy wording reviewed for this article identifies the product as Elevate with UIN ICIHLIP27057V062627 and the insurer with IRDAI registration number 115. The base policy pays admissible hospitalisation expenses subject to the sum insured, policy schedule, room entitlement, waiting periods, exclusions, co-payment or deductible if selected, and the claims rules. Optional covers can materially change the contract, so a buyer or policyholder must read the schedule together with the wording rather than treating every advertised feature as automatically included.

ICICI Lombard Elevate: Insurer, UIN and Policy Documents

The legal insurer is ICICI Lombard General Insurance Company Limited, not ICICI Bank and not an intermediary that may distribute the policy. The policy schedule records the insured persons, period, sum insured, premium, options, deductibles, co-payments and endorsements actually purchased. The proposal form, policy wording, schedule, customer information sheet and endorsements collectively form the contract. If a marketing page and the issued schedule differ, the schedule and operative wording should be checked before relying on a benefit.

A UIN is important because an older PDF may remain searchable even after a revised version is issued. This article uses the newer official wording published in 2026. Existing policyholders should still follow the UIN and wording attached to their own contract for the relevant policy year.

ICICI Lombard Elevate Base Hospitalisation Coverage

Elevate In-Patient Hospitalisation and Covered Charges

Under the basic in-patient cover, admissible hospitalisation expenses include room rent up to a single private air-conditioned room, intensive care charges, qualified nursing, medical practitioner fees, anaesthesia, blood, oxygen, operation-theatre charges, medicines, drugs and consumables other than listed non-medical exclusions, and specified surgical appliances or prosthetic devices used during surgery. Investigations must be directly connected with the covered illness or injury. Reasonable and customary charges, medical necessity, available sum insured and every applicable policy condition continue to apply.

Choosing a room above the entitlement may lead to proportionate payment of associated medical expenses. The wording states that the proportional deduction does not apply to ICU charges or where the hospital does not use differential billing for the relevant expenses. Pharmacy, consumables, implants, devices and diagnostics are outside the defined basket of “associated medical expenses” for this proportional calculation, though their independent admissibility still depends on the policy.

Elevate Day-Care and Pre-/Post-Hospitalisation Benefits

Covered day-care treatment may involve hospitalisation for less than 24 hours and includes medically necessary procedures such as chemotherapy, radiotherapy and haemodialysis, subject to the wording. Pure outpatient treatment and stand-alone diagnostic services are not transformed into day-care claims merely because they take place at a hospital. The policy provides pre-hospitalisation medical expenses for 90 days before admission and post-hospitalisation expenses for 180 days after discharge when the related main hospitalisation or day-care claim is accepted and the detailed conditions are met.

Other Base Benefits Subject to Elevate Policy Wording

The wording also provides, within its conditions, in-patient AYUSH hospitalisation at a recognised AYUSH hospital or day-care centre, domestic road ambulance expenses linked to an accepted hospitalisation or day-care claim, donor hospitalisation expenses for organ harvesting, and domiciliary hospitalisation. Each has its own trigger and limitations. For example, donor screening, acquisition of an organ, preservation or transport and the donor’s pre- or post-hospitalisation expenses are not automatically payable under the donor cover.

Elevate Reset Benefit and Optional Covers

The policy contains a reset mechanism, but it should not be described as an unrestricted second policy. The current wording says reset is not available with an unlimited sum insured, is not triggered for the first claim in the policy year and is capped at the sum insured for that policy year. The actual sequence of available base sum insured, bonuses and reset depends on the schedule and prior claims.

Elevate also contains numerous optional covers, including options addressing deductibles, co-payment, waiting-period reduction, worldwide treatment and other specified benefits. Optional wording does not mean automatic inclusion. Some options can be chosen only at inception, require continued purchase for a minimum period, carry separate waiting periods or do not apply to worldwide claims. The premium quotation and schedule should be used to confirm what was selected.

Pre-Existing Disease and Other Waiting Periods in Elevate

Waiting periods operate independently. Where more than one applies, the longer applicable period may control. Continuous prior coverage can provide portability or migration credits under regulatory rules, but those credits need to be recorded and accepted. A higher sum insured can attract a fresh waiting period for the enhanced portion.

The policy’s pre-existing disease definition looks back to conditions diagnosed, or for which medical advice or treatment was recommended or received, within the period specified by the applicable regulatory definition. Full and accurate disclosure in the proposal form remains essential. A reduced waiting-period option does not erase the need to disclose, and its own inception and continuation rules must be satisfied.

Elevate Exclusions, Room Eligibility and Claim Limits

The standard exclusions include investigation and evaluation admissions that are only diagnostic, rest cure and respite care, obesity or weight-control treatment except where the policy’s conditions are met, cosmetic or plastic surgery except specified situations, hazardous adventure sports, breach of law, excluded providers and items listed as non-medical expenses. The complete list is longer. A claim can also be affected by a permanent exclusion, loading, co-payment, voluntary deductible or room restriction shown on the individual schedule.

The network provider list is dynamic. Cashless treatment is a settlement method, not a guarantee that every expense will be allowed. An excluded or delisted provider, an unavailable cashless arrangement or a service outside the policy can require reimbursement processing or result in non-payment. Emergency treatment should never be delayed merely to obtain cashless approval, but the insurer should be notified promptly and documents preserved.

Elevate Purchase, Renewal, Cancellation and Continuity

Premium is quote-dependent. Age, location, family composition, medical disclosures, sum insured, term, optional covers, underwriting, deductible and co-payment can change the amount. It would therefore be misleading to publish a single premium as though it applied to every proposer. The proposal should be completed accurately; medical tests may be requested, and acceptance can be on standard terms, modified terms or not offered, subject to law and underwriting.

A new individual health policy has a 30-day free-look period beginning from receipt of the policy. Cancellation during that period permits a refund subject to the deductions and claim conditions in the wording. Outside free look, cancellation requires seven days’ written notice, with the refund governed by the current clause and the policy’s claim history. At renewal, continuity, grace-period payment and any proposed enhancement should be handled before expiry. The wording states that fresh underwriting is not carried out at renewal where there is no increase in sum insured, while an increase may be underwritten.

After 60 continuous months, including allowed portability and migration periods, the moratorium clause makes the policy and claims non-contestable except for established fraud. For an enhanced sum insured, the 60 months run separately for the enhanced limits from the date of enhancement.

ICICI Lombard Elevate Cashless and Reimbursement Claims

Elevate Cashless Pre-Authorisation at Network Hospitals

1. Identify an eligible network hospital and present the health card or policy details and identity documents.

2. Ask the hospital insurance desk to submit the pre-authorisation request. Planned treatment should be initiated early; emergencies should be notified as soon as practicable.

3. Answer medical-history queries accurately and provide previous records if requested. Authorisation is based on the information then available and can be revised after final documents.

4. At discharge, review deductions, non-medical items and the final authorisation. Keep copies of the discharge summary, bills and reports.

Elevate Reimbursement Claim Submission and Evidence

Where cashless is unavailable, the insured ordinarily pays the hospital and submits the prescribed claim form, policy and KYC details, discharge summary, original bills and receipts, prescriptions, investigation reports, implant invoices where relevant, bank details and any accident or medico-legal records. The insurer may seek additional documents reasonably needed to assess coverage. Submission does not itself establish admissibility; the illness, treatment, waiting periods, exclusions and sum-insured position are assessed under the contract.

ICICI Lombard Elevate Complaint and Grievance Process

The wording lists ICICI Lombard’s website, toll-free number 1800 2666, customer-support email and grievance address. The policyholder should first lodge a written complaint with the insurer and retain the complaint reference and documents. If the response is absent or unsatisfactory, the matter may be escalated through IRDAI’s Bima Bharosa portal and, where jurisdictional conditions are met, to the Insurance Ombudsman. Consumer-law or other legal remedies may also be available; the appropriate route depends on the dispute.

GST and Income-Tax Treatment of Elevate Premiums

From 22 September 2025, GST on individual health insurance policies, including family-floater and senior-citizen policies, was reduced to zero. The exemption does not convert every group or employer policy into an exempt individual policy. The invoice and policy classification should be checked for the specific contract.

For income tax, section 126 of the Income-tax Act, 2025 provides a deduction for qualifying health-insurance premium and specified medical or preventive-health expenditure for an eligible individual or Hindu undivided family, subject to category limits, mode-of-payment rules and the taxpayer’s chosen tax regime. The commonly relevant aggregate limit is ₹25,000, increased to ₹50,000 where the covered person in that block is a senior citizen; a separate parent block may apply. Preventive health check-up is included within, not added over, the applicable ceiling. Tax benefit is not a product feature guaranteed by the insurer, and eligibility should be tested for the relevant tax year.

Elevate Policy Document and Claim Verification Checklist

• Match the UIN on the quotation, policy schedule and wording.
• Confirm every insured person, date of birth, address, nominee and medical disclosure.
• Read the room entitlement and any co-payment or deductible.
• Identify waiting-period credits accepted for portability or migration.
• Separate basic cover from optional cover and record each selected option.
• Check the current network and excluded-provider lists before planned treatment.
• Keep proposal, schedule, endorsements, renewal receipts and claim records together.
• Use the actual premium receipt and applicable tax regime for any income-tax claim.

Frequently Asked Questions

Is Elevate issued by ICICI Bank?

No. The contracting insurer is ICICI Lombard General Insurance Company Limited. A bank or other distributor does not replace the insurer under the policy contract.

Does the base policy allow any hospital room?

The current basic wording states room rent up to a single private AC room. Choosing a higher category can lead to proportionate deductions for associated medical expenses under the policy rules.

Are all optional benefits automatically included?

No. An optional cover applies only when selected, accepted, paid for where required and recorded in the policy schedule. Some options have separate eligibility and waiting conditions.

What is the pre-existing disease waiting period?

The current wording specifies 36 months, subject to disclosure, acceptance and recognised continuity credits. Eligible reduction options may shorten it to 24 or 12 months under their conditions.

Does cashless approval mean the entire bill will be paid?

No. Cashless is a settlement facility. Non-medical items, exclusions, limits, proportionate deductions, deductibles and co-payments can remain payable by the insured.

Is GST charged on an individual Elevate policy in 2026?

Individual and family-floater health insurance policies are GST-exempt from 22 September 2025. The invoice and classification should be checked, particularly for group arrangements.

Can the premium qualify for an income-tax deduction?

Qualifying premium may be deductible under section 126 of the Income-tax Act, 2025, subject to limits, payment mode and the tax regime selected. The taxpayer should preserve the premium receipt.

Where can a rejected or delayed claim be escalated?

Start with ICICI Lombard’s grievance channel. Depending on the response and eligibility, escalate through IRDAI Bima Bharosa or the Insurance Ombudsman and consider other lawful remedies.

Key Takeaways

• The current official wording identifies Elevate UIN ICIHLIP27057V062627 and insurer IRDAI registration 115.
• The base cover includes in-patient treatment, specified day care and claim-linked pre- and post-hospitalisation, subject to the schedule and exclusions.
• Waiting periods, room entitlement, optional covers and underwriting terms can materially change claim outcomes.
• Cashless treatment is a settlement route, not a promise that every billed item is payable.
• Individual health policies are GST-exempt from 22 September 2025; income-tax deduction remains subject to section 126 and the applicable tax regime.

Source Links

• https://www.icicilombard.com/docs/default-source/default-document-library/elevate.pdf
• https://www.icicilombard.com/docs/default-source/default-document-library/elevate-prospectus_.pdf
• https://www.icicilombard.com/health-insurance
• https://www.icicilombard.com/customer-support
• https://bimabharosa.irdai.gov.in/
• https://financialservices.gov.in/exemption-gst-all-individual-life-insurance-and-health-insurance-policies
• https://www.incometaxindia.gov.in/w/section-126-92

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Disclaimer: This article is a general educational summary based on the official material reviewed on 19 October 2026 and is not insurance, medical, tax or legal advice, an endorsement, or a recommendation to buy, renew or cancel any policy. Benefits, eligibility, premium, underwriting, network status and claim decisions depend on the issued policy schedule, current wording, disclosures and facts of each case. Readers should verify the latest documents with the insurer and consult an appropriate professional where required. TaxGuru accepts no responsibility for any loss, claim outcome, tax position, decision or consequence arising from reliance on this article. Health-insurance protection is determined by the issued policy schedule, operative policy wording, endorsements, disclosures, underwriting decisions and the circumstances of each claim, not by an abbreviated feature summary. Confirm the precise variant, sum insured, premium, optional riders, exclusions, waiting periods, sub-limits, deductibles, co-payments, restoration provisions and network hospital conditions before buying or renewing. A benefit shown in marketing material may not be included in the issued contract or may be subject to eligibility and medical necessity tests. Cashless pre-authorisation is not an unconditional promise that the full hospital bill will be paid; non-payable items, limits and documentation requirements may remain. The treatment of pre-existing conditions, non-disclosure, portability, renewal, cancellation and grievance escalation can depend on the applicable IRDAI framework and policy wording. Tax and GST treatment may vary with the insured person’s circumstances, payment structure and law in force at the relevant time. Policyholders should retain proposal forms, disclosures, receipts, medical records, claim correspondence and insurer decisions. For claim disputes, serious medical issues or complex tax questions, consult a qualified insurance, medical, legal or tax professional as appropriate. TaxGuru is not an insurer, medical provider or claims adjudicator and accepts no responsibility for denied claims, coverage gaps, premium changes, losses or decisions based on this article.