THE PERFECT HEALTH SHIELD FOR

YOU & YOUR FAMILY.

Comprehensive Convenient Focuses on Health and Wellness

INTRODUCTION
• A comprehensive health policy exclusively for YES Bank customers that
focuses on their well being through preventive services.

• The policy works to prevent hospitalisation and in case of hospitalisation,

it also takes care of the expenses.
• Through a unique set of solutions, Health Shield 360 meets your
healthcare and wellness needs.
 HEALTH SHIELD 360: KEY FEATURES

Age limit up to 75 years

Entry age limit up to 75 years
KEY FEATURES AND DEFINITIONS

Hospitalisation Cover
Expenses pertaining to in-patient hospitalisation such as room rent, intensive
care unit charges, surgeon’s and doctor’s fee, anesthesia, blood, oxygen,
operation theatre charges etc. incurred during hospitalisation for a minimum
period of 24 consecutive hours are covered under the basic hospitalisation
cover.

Day Care Surgeries/ Treatments Coverage

Medical expenses incurred while undergoing Day Care Procedures/
Treatment which require less than 24 hours hospitalisation are covered.

Pre and Post Hospitalisation Expenses

Medical expenses incurred, immediately, 90 days before and 180 days after
hospitalisation will be covered.

In Patient AYUSH Treatment

Expenses for Ayurveda, Yoga and Naturopathy, Unani, Siddha and
Homeopathy (AYUSH) treatment only when it has been undergone in a AYUSH
hospital or in AYUSH Day Care Center.

Unlimited Reset Benefit

We will reset up to 100% of the base Sum Insured unlimited times in a policy year
in case the Sum Insured including accrued additional Sum Insured (if any), Super
No Claim Bonus (if any) & Sum Insured Protector (if any) is insufficient as a result
of previous claims in that policy year. The reset amount can only be used for all
future claims within the same policy year, not related to the illness for which a
claim has been paid in that policy year for the same person.

Additional Sum Insured (ASI)

An Additional Sum Insured of 10% of Annual Sum Insured provided on each
renewal for every claim free year up to a maximum of 100%. In case of a claim
under the policy, the accumulated Additional Sum Insured will be reduced by 10%
of the Annual Sum Insured in the following year.
 Home Health Care
In this benefit we will cover the medical expenses incurred by you on availing
treatment at home as prescribed by a medical practitioner.
KEY FEATURES AND DEFINITIONS

Claim Protector*
In case the customer has opted for this cover, the IRDAI list of non-payable items
shall become payable in case of a claim.

Additional Sum Insured (ASI) Protector*

ASI accrued by the customer shall not be impacted if any one claim or multiple
claims admissible in the previous year does not exceed the overall amount of
`50,000.

360 Wellbeing program

360 Wellbeing program aims to empower individuals to manage their lifestyle
and prevent complications arising from adverse health conditions. It intends
to promote, incentivise and reward individuals for healthy behavior through
various health and wellbeing activities.

Air Ambulance Cover

Air Ambulance expenses incurred to transfer the Insured Person following an
emergency to the nearest Hospital up to Sum Insured on cumulative basis.

Domestic Road Emergency Ambulance Cover

The expenses incurred on road ambulance services which are offered by a
healthcare or ambulance service provider to transfer an individual to the
nearest Hospital with adequate emergency facilities for the provision of
Emergency Care is covered.

Donor Expenses
Medical Expenses incurred in respect of the donor for any organ transplant
surgery, provided the organ donated is for the insured person’s use.

Domiciliary Hospitalisation
Coverage for medical expenses in a situation where the Insured Person is in
such a state that he/ she cannot be moved to a hospital or the treatment is
taken at home, if there's a non-availability of room in the hospital.

*Optional add on cover available by paying additional premium

 PED covered after 12 months
Declared and accepted Pre-Existing Diseases will be covered after 12 months
waiting period. Any non-declaration of PED will lead to rejection of claims and
cancellation of policy.

Out-Patient Treatment Cover

KEY FEATURES AND DEFINITIONS

Outpatient (OPD) medical expenses covered on cashless and reimbursement

basis.

Maternity Benefit*
Reimbursement for medical expenses incurred for delivery, including a
cesarean section, during hospitalisation or lawful medical termination of
pregnancy during the policy period. The waiting period for maternity cover is 3
years. The cover shall be limited to 2 deliveries/ terminations during the period
of insurance. Pre - Natal and Post - Natal expenses shall be covered under this
benefit. This cover is applicable only for floater plan having Self and Spouse in
the same policy.

Newborn Baby Cover*

The newborn child can be covered under this policy during hospitalisation for
a maximum period up to 91 days from the date of birth of the child. This cover
will be provided only if maternity cover is opted.

Super No-Claim Bonus*

In case the customer has opted for this cover, there will be a 50% bonus
awarded for every claim free year subject to a maximum of 100%. In the event
of a claim in the Policy year, the Super No-Claim Bonus will reduce by 50%.

Compassionate Visit
In the event of hospitalisation exceeding 5 days, the cost of economy class air
ticket up to a certain amount (as per the plan chosen) incurred by the
customer’s “immediate family member” while travelling to place of
hospitalisation from the place of origin/ residence and back will be
reimbursed. “Immediate family member” would mean spouse, children and
dependent parents.

*Optional add on cover available by paying additional premium

 COVERS WITH THEIR INDIVIDUAL SUM INSURED LIMITS
OPD Cover
Covers Out Patient medical expenses for doctor consultation, Prescribed
Pharmacy and diagnostics up to the limit as specified below. This cover will be
applicable only within the geographical boundaries of India.
KEY FEATURES AND DEFINITIONS

• Maximum limit of Rs 5,000 for SI 5L/ 10L

• Maximum limit of Rs 10,000 for SI 25L/ 50L
• Maximum limit of Rs 15,000 for SI 75L/ 100L

Domestic Road Emergency Ambulance Cover

Covers road ambulance expenses, incurred to transfer the Insured following an
emergency to the nearest hospital per event of emergency hospitalisation,
provided we have accepted the in-patient claim.
• For SI Rs.5L/ 10L = up to a maximum limit of Rs. 3,000
• For SI Rs.25L/ 50L = up to a maximum limit of Rs. 7,000

Maternity Cover
Medical Expenses incurred for delivery of child, where You and Your spouse, both
are covered under the same family floater Policy and have served the waiting
period of 3 years up to the limit as specified below. This cover will be applicable
only within the geographical boundaries of India.
• SI 5L= Maternity limit Rs 25,000 for both normal and C section, maximum upto
2 events
• SI 10L= Maternity limit Rs 50,000 for both normal and C section, maximum
upto 2 events
• SI 25L= Maternity limit Rs 75,000 for both normal and C section, maximum
upto 2 events
• SI 50L/ 75L/ 100L = Maternity limit Rs 1,00,000 for both normal and C section,
maximum upto 2 events

New born baby cover

Medical Expenses incurred towards the treatment of a New Born Baby, up to 90
days from date of birth, if a Maternity Benefit claim has been accepted up to the
limit as specified below. This cover will be applicable only within the geographical
boundaries of India.
• SI 5L/10L= Maximum limit Rs 10,000
• SI 25L & above= Maximum limit Rs 1,00,000
 Road Emergency Ambulance (worldwide including India)
Covers road ambulance expenses, incurred to transfer the Insured following an
emergency to the nearest hospital per event of emergency hospitalisation,
provided we have accepted the in-patient claim up to a maximum limit of Rs.
35000 for overseas claims & Rs.10,000 for Domestic claims
KEY FEATURES AND DEFINITIONS

Compassionate Visit
We will reimburse the cost of the economy class air ticket incurred by Your
Immediate family from and to the place of origin of such immediate family or the
place of residence of the immediate family up to Rs.20, 000. This cover will be
applicable only within the geographical boundaries of India.
 HEALTH SHIELD 360 – COVERAGE OPTIONS
Health Shield 360 offers 5 unique combinations of coverage that will offer a host
of benefits to cater to your healthcare needs.

Options
Cover Names
Basic Enhanced Preferred Premium Worldwide

Sum Insured
5L, 10L, 5L, 10L, 5L, 10L, 5L, 10L, 50L, 75L,
25L, 50L 25L, 50L 25L, 50L 25L, 50L 100L

In-patient Hospitalisation

Day Care Treatment/Surgeries

Pre - Post Hospitalisation

In Patient AYUSH Hospitalisation

Unlimited Reset Benefit

Additional Sum Insured

Donor Expenses

Domiciliary Hospitalization

Domestic Road Emergency Ambulance Cover

Air Ambulance (India)

Home Healthcare

OPD Cover

Compassionate Visit

360 Well Being Program

Maternity Cover

New born baby cover

Claim Protector

ASI Protector

Super No Claim Bonus

Worldwide cover for Hospitalisation

Road Emergency Ambulance (worldwide)

Air Ambulance (worldwide)

 HEALTH SHIELD 360 - DOMESTIC COVERAGES
Domestic coverages offer a range of sum insured to cover your family with multple options
to provide protection against medical and healthcare requirements that suit your needs.

Unlimited Reset cover**

OPD cover
DOMESTIC COVERAGES

Additional Sum Insured

HEALTH SHIELD 360 -

ASI Protector

Super NCB

Claim Protector

Compassionate Visit

Maternity and Newborn Baby Cover

Note : **Reset will be available unlimited times in a policy year in case the Sum insured including accrued Additional Sum Insured (if any) and Super No-Claim Bonus
(if any), Sum insured protector (if any) is insufficient as a result of previous claims in that policy year. Reset will not trigger for the first claim. Reset will not trigger for
same person with same illness for which a claim has been paid in that policy year.
 BASIC COVERAGES (Premium Excluding GST)
Sum Insured = `5 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 7,437 9,248 10,699 10,505 13,042 16,113 17,673
26-30 8,454 9,896 11,467 11,822 13,903 17,400 19,095
31-35 8,421 9,863 11,434 11,756 13,837 17,334 19,029
36-40 9,758 11,461 12,692 14,366 16,106 17,978 20,340
41-45 9,801 11,504 12,735 14,452 16,192 18,064 20,426
46-50 12,592 15,261 16,047 19,832 21,616 22,720 25,061
51-55 16,842 18,655 19,691 27,856 28,747 29,488 31,951
(PREMIUM EXCLUDING GST)

56-60 23,506 24,502 25,911 39,464 41,804 43,173 46,389

61-65 30,351 31,520 32,823 52,431 55,055 57,417 60,721
66-70 40,086 42,887 46,317 74,126 76,152 78,582 81,606
71-75 44,174 47,425 50,746 82,050 84,276 86,951 90,290
Sum Insured = 10 Lakhs
BASIC COVERAGES

Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K

0-25 8,328 10,160 11,789 11,561 14,447 17,951 19,674
26-30 9,548 10,928 12,699 13,084 15,445 19,479 21,360
31-35 9,515 10,895 12,667 13,018 15,379 19,413 21,294
36-40 11,197 12,785 14,168 16,086 18,062 20,189 22,888
41-45 11,240 12,828 14,211 16,172 18,148 20,275 22,974
46-50 14,761 17,269 18,133 22,501 24,541 25,781 28,469
51-55 19,970 21,203 22,358 31,826 32,814 33,628 36,456
56-60 28,143 28,600 29,527 45,269 47,943 49,487 53,187
61-65 36,559 36,889 37,650 60,462 63,471 66,174 69,986
66-70 48,409 49,387 53,346 85,553 87,855 90,627 94,104
71-75 53,478 54,731 58,564 94,864 97,398 100,458 104,304
Sum Insured = 25 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 11,948 14,316 16,418 16,012 19,760 24,318 26,544
26-30 13,543 15,318 17,607 17,999 21,060 26,313 28,745
31-35 13,510 15,285 17,574 17,934 20,994 26,247 28,679
36-40 15,699 17,746 19,527 21,923 24,479 27,235 30,738
41-45 15,742 17,789 19,570 22,009 24,565 27,321 30,824
46-50 20,320 23,573 24,673 30,232 32,873 34,465 37,955
51-55 27,104 28,687 30,169 42,370 43,633 44,666 48,339
56-60 37,768 39,214 40,851 59,894 63,366 67,769 73,454
61-65 48,737 50,047 51,365 83,064 89,655 91,512 96,382
66-70 64,181 69,290 73,250 118,560 121,697 124,125 127,701
71-75 70,821 76,747 80,339 131,474 134,934 137,602 141,551
Sum Insured = 50 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 13,813 16,722 19,295 18,751 23,410 29,095 31,825
26-30 15,829 17,989 20,798 21,263 25,051 31,616 34,607
31-35 15,797 17,956 20,765 21,197 24,985 31,550 34,541
36-40 18,558 21,062 23,227 26,228 29,376 32,777 37,125
41-45 18,601 21,105 23,270 26,314 29,462 32,863 37,211
46-50 24,373 28,404 29,708 36,675 39,930 41,857 46,189
51-55 32,936 34,852 36,638 51,988 53,498 54,716 59,280
56-60 46,412 48,154 50,138 74,120 78,429 83,918 91,032
61-65 60,264 61,833 63,413 103,385 111,647 113,909 119,990
66-70 79,765 86,148 91,075 148,226 152,110 155,097 159,537
71-75 88,178 95,598 100,059 164,591 168,884 172,174 177,088
 ENHANCED COVERAGES (Premium Excluding GST)
Sum Insured = `5 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 7,437 9,248 10,699 11,416 13,953 17,024 18,584
26-30 8,454 9,896 11,467 12,578 14,659 18,156 19,852
31-35 8,421 9,863 11,434 12,614 14,694 18,191 19,887
36-40 9,758 11,461 12,692 15,147 16,887 18,759 21,121
41-45 9,801 11,504 12,735 15,093 16,832 18,704 21,067
46-50 12,592 15,261 16,047 20,254 22,039 23,142 25,484
51-55 16,842 18,655 19,691 27,856 28,747 29,488 31,951
(PREMIUM EXCLUDING GST)

56-60 23,506 24,502 25,911 39,464 41,804 43,173 46,389

61-65 30,351 31,520 32,823 52,431 55,055 57,417 60,721
66-70 40,086 42,887 46,317 74,126 76,152 78,582 81,606
ENHANCED COVERAGES

71-75 44,174 47,425 50,746 82,050 84,276 86,951 90,290

Sum Insured = 10 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 8,328 10,160 11,789 13,256 16,141 19,645 21,369
26-30 9,548 10,928 12,699 14,492 16,852 20,886 22,767
31-35 9,515 10,895 12,667 14,614 16,975 21,008 22,889
36-40 11,197 12,785 14,168 17,538 19,514 21,641 24,340
41-45 11,240 12,828 14,211 17,363 19,339 21,466 24,165
46-50 14,761 17,269 18,133 23,287 25,327 26,566 29,255
51-55 19,970 21,203 22,358 31,826 32,814 33,628 36,456
56-60 28,143 28,600 29,527 45,269 47,943 49,487 53,187
61-65 36,559 36,889 37,650 60,462 63,471 66,174 69,986
66-70 48,409 49,387 53,346 85,553 87,855 90,627 94,104
71-75 53,478 54,731 58,564 94,864 97,398 100,458 104,304
Sum Insured = 25 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 11,948 14,316 16,418 19,336 23,085 27,643 29,869
26-30 13,543 15,318 17,607 20,760 23,821 29,073 31,505
31-35 13,510 15,285 17,574 21,063 24,124 29,376 31,808
36-40 15,699 17,746 19,527 24,772 27,328 30,083 33,586
41-45 15,742 17,789 19,570 24,346 26,902 29,657 33,160
46-50 20,320 23,573 24,673 31,773 34,414 36,006 39,496
51-55 27,104 28,687 30,169 42,370 43,633 44,666 48,339
56-60 37,768 39,214 40,851 59,894 63,366 67,769 73,454
61-65 48,737 50,047 51,365 83,064 89,655 91,512 96,382
66-70 64,181 69,290 73,250 118,560 121,697 124,125 127,701
71-75 70,821 76,747 80,339 131,474 134,934 137,602 141,551
Sum Insured = 50 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 13,813 16,722 19,295 22,859 27,518 33,203 35,933
26-30 15,829 17,989 20,798 24,674 28,462 35,027 38,018
31-35 15,797 17,956 20,765 25,064 28,852 35,417 38,408
36-40 18,558 21,062 23,227 29,748 32,896 36,297 40,645
41-45 18,601 21,105 23,270 29,201 32,350 35,750 40,099
46-50 24,373 28,404 29,708 38,579 41,835 43,761 48,093
51-55 32,936 34,852 36,638 51,988 53,498 54,716 59,280
56-60 46,412 48,154 50,138 74,120 78,429 83,918 91,032
61-65 60,264 61,833 63,413 103,385 111,647 113,909 119,990
66-70 79,765 86,148 91,075 148,226 152,110 155,097 159,537
71-75 88,178 95,598 100,059 164,591 168,884 172,174 177,088
 PREFERRED COVERAGES (Premium Excluding GST)
Sum Insured = `5 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 7,966 10,194 12,083 11,504 14,514 18,035 20,016
26-30 9,149 11,008 13,016 13,153 15,706 19,654 21,770
31-35 9,116 10,975 12,984 13,087 15,641 19,588 21,704
36-40 10,649 12,770 14,439 16,092 18,304 20,627 23,410
41-45 10,788 12,892 14,552 16,332 18,538 20,791 23,581
46-50 14,193 17,246 18,447 22,792 25,093 26,500 29,260
51-55 18,894 21,056 22,501 31,612 33,039 34,058 36,938
(PREMIUM EXCLUDING GST)

56-60 26,494 27,978 29,775 45,247 48,156 49,634 53,254

61-65 34,890 36,741 38,408 61,833 64,844 67,126 70,820
PREFERRED COVERAGES

66-70 45,887 49,372 53,164 86,053 88,467 90,817 94,231

71-75 50,822 54,757 58,441 95,671 98,284 100,880 104,608
Sum Insured = 10 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 8,909 11,211 13,330 12,665 16,076 20,083 22,280
26-30 10,317 12,167 14,428 14,563 17,449 21,987 24,341
31-35 10,284 12,134 14,395 14,498 17,384 21,921 24,275
36-40 12,189 14,247 16,120 18,011 20,512 23,143 26,314
41-45 12,328 14,368 16,233 18,250 20,746 23,306 26,485
46-50 16,519 19,463 20,796 25,775 28,384 29,980 33,140
51-55 22,212 23,847 25,465 35,964 37,541 38,684 41,983
56-60 31,405 32,403 33,771 51,601 54,897 56,601 60,759
61-65 41,502 42,568 43,744 70,672 74,121 76,798 81,051
66-70 54,779 56,493 60,867 98,618 101,358 104,104 108,023
71-75 60,805 62,794 67,042 109,841 112,815 115,848 120,136
Sum Insured = 25 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 12,707 15,689 18,431 17,454 21,888 27,104 29,947
26-30 14,547 16,937 19,865 19,933 23,680 29,589 32,639
31-35 14,514 16,904 19,832 19,867 23,614 29,523 32,573
36-40 16,995 19,657 22,077 24,441 27,683 31,095 35,216
41-45 17,164 19,803 22,212 24,728 27,962 31,283 35,413
46-50 22,621 26,443 28,155 34,517 37,901 39,958 44,063
51-55 30,040 32,148 34,232 47,787 49,818 51,282 55,569
56-60 42,040 44,191 46,404 68,185 72,468 77,080 83,363
61-65 55,211 57,482 59,342 96,436 103,601 105,420 110,868
66-70 72,524 78,594 83,096 135,670 139,380 141,772 145,924
71-75 80,417 87,305 91,439 151,091 155,124 157,755 162,281
Sum Insured = 50 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 14,772 18,458 21,840 20,575 26,101 32,618 36,128
26-30 17,100 20,036 23,654 23,709 28,364 35,760 39,533
31-35 17,067 20,003 23,621 23,643 28,299 35,695 39,467
36-40 20,199 23,480 26,453 29,414 33,430 37,662 42,791
41-45 20,401 23,653 26,613 29,755 33,761 37,877 43,018
46-50 27,287 32,037 34,114 42,101 46,297 48,811 53,920
51-55 36,654 39,233 41,782 58,849 61,330 63,093 68,433
56-60 51,823 54,457 57,169 84,622 89,958 95,710 103,579
61-65 68,466 71,251 73,516 120,326 129,313 131,526 138,336
66-70 90,335 97,935 103,547 169,904 174,513 177,451 182,620
71-75 100,336 108,972 114,119 189,445 194,462 197,704 203,347
 PREMIUM COVERAGES (Premium Excluding GST)
Sum Insured = `5 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 7,966 10,194 12,083 12,415 15,425 18,946 20,927
26-30 9,149 11,008 13,016 13,910 16,463 20,411 22,527
31-35 9,116 10,975 12,984 13,945 16,498 20,446 22,562
36-40 10,649 12,770 14,439 16,873 19,085 21,408 24,191
41-45 10,788 12,892 14,552 16,972 19,179 21,431 24,221
46-50 14,193 17,246 18,447 23,215 25,516 26,923 29,683
51-55 18,894 21,056 22,501 31,612 33,039 34,058 36,938
(PREMIUM EXCLUDING GST)

56-60 26,494 27,978 29,775 45,247 48,156 49,634 53,254

61-65 34,890 36,741 38,408 61,833 64,844 67,126 70,820
66-70 45,887 49,372 53,164 86,053 88,467 90,817 94,231
PREMIUM COVERAGES

71-75 50,822 54,757 58,441 95,671 98,284 100,880 104,608

Sum Insured = 10 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 8,909 11,211 13,330 14,360 17,771 21,778 23,975
26-30 10,317 12,167 14,428 15,971 18,857 23,394 25,748
31-35 10,284 12,134 14,395 16,093 18,979 23,516 25,870
36-40 12,189 14,247 16,120 19,463 21,964 24,595 27,766
41-45 12,328 14,368 16,233 19,441 21,937 24,498 27,676
46-50 16,519 19,463 20,796 26,561 29,170 30,766 33,925
51-55 22,212 23,847 25,465 35,964 37,541 38,684 41,983
56-60 31,405 32,403 33,771 51,601 54,897 56,601 60,759
61-65 41,502 42,568 43,744 70,672 74,121 76,798 81,051
66-70 54,779 56,493 60,867 98,618 101,358 104,104 108,023
71-75 60,805 62,794 67,042 109,841 112,815 115,848 120,136
Sum Insured = 25 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 12,707 15,689 18,431 20,779 25,213 30,428 33,272
26-30 14,547 16,937 19,865 22,693 26,440 32,350 35,399
31-35 14,514 16,904 19,832 22,996 26,743 32,652 35,702
36-40 16,995 19,657 22,077 27,289 30,531 33,944 38,064
41-45 17,164 19,803 22,212 27,064 30,299 33,620 37,750
46-50 22,621 26,443 28,155 36,059 39,442 41,499 45,604
51-55 30,040 32,148 34,232 47,787 49,818 51,282 55,569
56-60 42,040 44,191 46,404 68,185 72,468 77,080 83,363
61-65 55,211 57,482 59,342 96,436 103,601 105,420 110,868
66-70 72,524 78,594 83,096 135,670 139,380 141,772 145,924
71-75 80,417 87,305 91,439 151,091 155,124 157,755 162,281
Sum Insured = 50 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 14,772 18,458 21,840 24,683 30,209 36,726 40,237
26-30 17,100 20,036 23,654 27,120 31,776 39,172 42,944
31-35 17,067 20,003 23,621 27,510 32,165 39,561 43,333
36-40 20,199 23,480 26,453 32,934 36,950 41,182 46,311
41-45 20,401 23,653 26,613 32,642 36,649 40,764 45,905
46-50 27,287 32,037 34,114 44,006 48,201 50,715 55,824
51-55 36,654 39,233 41,782 58,849 61,330 63,093 68,433
56-60 51,823 54,457 57,169 84,622 89,958 95,710 103,579
61-65 68,466 71,251 73,516 120,326 129,313 131,526 138,336
66-70 90,335 97,935 103,547 169,904 174,513 177,451 182,620
71-75 100,336 108,972 114,119 189,445 194,462 197,704 203,347
 HEALTH SHIELD 360 - WORLDWIDE COVERAGES
The worldwide coverages offer a higher Sum Insured with a worldwide hospitalisation cover
for emergency and planned hospitalisation requirements.

Worldwide cashless facility at network centers*

Daycare procedures
WORLDWIDE COVERAGES

International emergency medical services

(Air & Roadside ambulance)
HEALTH SHIELD 360 -

Note : Worldwide cover benefit is available only when Insured member (Indian resident) is travelling abroad and his single trip is not more than 45 days and multiple
trips taken abroad by customer in a policy year is not more than 90 days. The scope of this cover extends to worldwide including India, USA and Canada and the
Maximum limit of indemnity would be restricted to the Annual Sum insured for claims within and outside India, in aggregate. A co-pay of 10% will be applied to every
admissible claim, if the treatment is taken outside India.
*as per availability.
 WORLDWIDE COVERAGES (Premium Excluding GST)
Sum Insured = 50 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 21,477 27,118 32,201 34,538 43,345 53,919 59,250
26-30 22,787 26,691 31,617 35,245 41,720 52,388 57,563
31-35 22,754 26,659 31,585 35,635 42,110 52,778 57,953
36-40 39,957 46,380 52,003 62,672 70,770 79,452 90,413
41-45 40,160 46,553 52,162 62,380 70,469 79,035 90,007
46-50 58,182 68,851 72,460 93,109 101,975 107,023 118,534
51-55 100,428 106,602 112,449 164,012 169,152 172,902 187,947
(PREMIUM EXCLUDING GST)

56-60 113,817 118,556 123,740 186,645 197,968 211,493 229,594

61-65 192,757 198,299 203,343 339,431 366,395 372,940 392,768
WORLDWIDE COVERAGES

66-70 258,479 279,791 295,803 489,987 502,623 511,543 526,004

71-75 276,330 300,069 313,993 525,216 538,652 548,169 563,557
Sum Insured = 75 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 24,899 31,016 36,522 38,699 48,273 59,778 65,555
26-30 26,270 30,480 35,803 39,446 46,456 58,032 63,627
31-35 26,237 30,447 35,770 39,836 46,845 58,422 64,017
36-40 45,276 52,278 58,401 69,764 78,605 88,088 100,075
41-45 45,490 52,461 58,569 69,491 78,322 87,680 99,680
46-50 65,295 76,971 80,885 103,345 113,035 118,535 131,136
51-55 111,985 118,737 125,125 181,883 187,486 191,569 208,097
56-60 126,318 131,469 137,113 206,102 218,486 233,306 253,143
61-65 213,597 219,636 225,141 374,895 404,562 411,742 433,542
66-70 285,954 309,378 326,972 540,677 554,549 564,348 580,232
71-75 305,460 331,547 346,834 579,179 593,928 604,378 621,278
Sum Insured = 100 Lakhs
Age / SI Individual 1A+1K 1A+2K 2A 2A+1K 2A+2K 2A+3K
0-25 26,140 32,653 38,513 40,552 50,760 63,033 69,183
26-30 27,594 32,067 37,729 41,381 48,845 61,189 67,141
31-35 27,561 32,034 37,696 41,771 49,235 61,579 67,531
36-40 47,956 55,421 61,945 73,849 83,281 93,400 106,199
41-45 48,182 55,613 62,121 73,594 83,015 93,001 105,814
46-50 69,370 81,838 85,999 109,878 120,219 126,078 139,535
51-55 119,373 126,575 133,385 194,119 200,088 204,432 222,100
56-60 134,638 140,122 146,134 219,908 233,131 248,965 270,165
61-65 228,121 234,556 240,422 400,676 432,410 440,073 463,385
66-70 305,562 330,610 349,420 578,114 592,938 603,404 620,383
71-75 326,417 354,315 370,653 619,280 635,041 646,204 664,268
 TERMS & CONDITIONS

Eligibility
• Exclusive offering for Indian resident customers holding a relationship with YES Bank
• Adults from 21 to 75 years of age, Children from 91 days to 20 years of age; child will be
covered under floater plan only

Tenure
1 Year
TERMS & CONDITIONS

Family definition
Self, Spouse, Dependent parents, Dependent siblings and max. 3 dependent children
upto 20 yrs. of Age

Room rent restriction

Nil

Affluent Segment Mass Segment

1. No pre-policy check-up 1. No pre-policy check-up
required up to 60 years required up to 55 years

2. Medical check-up will trigger 2. Medical check-up will trigger

for any of the below criterion: for any of the below criterion:
• Customer with age of 61 years and • Customer with age of 56 years &
above above
• Customer selecting sum insured of • Customer selecting sum insured of
75 lakhs or above 25 lakhs or above
• Any customer declaring a • Any customer declaring a
pre-existing disease pre-existing disease

Waiting Period
• Initial Waiting Period: 30 days for all illnesses (except hospitalisation due to
injury).
• Expense related to hypertension, diabetes, and cardiac conditions within 90 days
from the policy commencement date unless they are PED.
• Pre-existing diseases: 12 months waiting period for declared and accepted PEDs.
• Specific disease waiting period: 2 years, for specific Illness and treatment. (Please
refer to the policy clauses for the full listing).
• Maternity Cover: 3 years, provided both Insured Person and Spouse are covered
under the same Policy.

Specific exclusions
Standard list of diseases & procedures (kindly refer to 2 year exclusion list) will be
covered after 24 months of continuous coverage
 Pre-existing disease(s) (PED)
• Declared & accepted PEDs will be covered after 1 year waiting period
• PED needs to be declared by insured for all insured members in policy
• Any non-declaration of PED will lead to rejection of claims and cancellation of policy

Maternity cover
This cover can be availed only if both the insured & spouse are covered under the same plan
for a continuous duration of 36 months
TERMS & CONDITIONS

Conditional Underwriting
• When an insured member declares a pre existing illness, a medical underwriting is done for
such proposal. On the basis of the medical underwriting the proposal is either accepted
with loading on premium or its rejected
• Customer is enrolled in the policy with loading on premium and also becomes part of
Be-Healthy program of 360 Wellbeing Program

Free Look Period

The insured person shall be allowed free look period of fifteen days from date
of receipt of the policy document to review the terms and conditions of the
policy, and to return the same if not acceptable

What We Will Not Pay

(This is an indicative list of exclusions. For complete details please refer the
policy wordings)

We shall not be liable to make any payment under this Policy in connection
with or in respect of any expenses whatsoever incurred by you in connection
with or in respect of:

Specified disease/ procedure waiting period:

a) Expenses related to the treatment of the listed Conditions, surgeries/

treatments shall be excluded until the expiry of the 24 month coverage
after the date of inception of the first policy with us. This exclusion shall
not be applicable for claims arising due to an accident

b) Any Expenses related to the treatment of Hypertension, Diabetes, cardiac

conditions within 90 days from the first policy start date
- In case of enhancement of Sum Insured the exclusion shall apply afresh
to the extent of sum insured increase

STANDARD LIST OF DISEASES & PROCEDURES WILL BE COVERED AFTER

24 MONTHS OF CONTINUOUS COVERAGE.
 LIST OF SPECIFIC DISEASES/ PROCEDURE
| Cataract

| Benign Prostatic Hypertrophy

| Myomectomy, Hysterectomy unless because of malignancy

| All types of Hernia, Hydrocele

| Fissures &/or Fistula in anus, hemorrhoids/ piles

LIST OF SPECIFIC DISEASES/

| Arthritis, gout, rheumatism and spinal disorders

| Joint replacements unless due to accident

| Sinusitis and related disorders

| Stones in the urinary and biliary systems

| Dilatation and curettage, Endometriosis

| All types of Skin and internal tumors/ cysts/ nodules/ polyps

PROCEDURE

of any kind including breast

| Lumps unless malignant

| Dialysis required for chronic renal failure

| Surgery on tonsils, adenoids and sinuses

| Gastric and Duodenal erosions & ulcers

| Deviated Nasal Septum

| Varicose Veins/ Varicose Ulcers

| All types of internal congenital anomalies/ illness/ defects

MAJOR PERMANENT EXCLUSIONS

(This is an indicative list of exclusions. For complete details please refer the
policy wordings)
• Medical expenses incurred during the first 30 days of inception of the
policy, except those arising out of accidents. This exclusion doesn’t apply for
subsequent renewals without a break
• Expenses attributable to self-inflicted injury (resulting from suicide,
attempted suicide)
• Expenses arising out of or attributable to alcohol or drug use/ misuse/
abuse
• Cost of spectacles/ contact lenses, dental treatment
• Medical treatment expenses traceable to childbirth (including complicated
deliveries and caesarean sections incurred during hospitalisation) except
ectopic pregnancy
IL TAKECARE
A one stop solution for your insurance and wellness needs. Download the IL TakeCare app to avail
the following services and much more as per your policy, all at the ease of your fingertips.

• Convenient & Easy-To-Use app

• Wide range of Emergency & Convenient Medical solutions at your fingertips 24x7 as per the policy

• Quick Claim Process

• Wellness Programs to help keep you fit

DIGITAL POLICY

E CARDS CASHLESS OPD

EMERGENCY
WELLNESS AMBULANCE
SERVICES

TELE
CONSULTATION CLAIMS

Download the App now

https://apple.co/2nNyPya https://bit.ly/2n5vkmt
360 WELLBEING PROGRAM
Based on your declaration of pre-existing disease and/or results of pre-policy medical check-up
(PPMC), You will be categorized in the Green & Amber Category & will earn points accordingly as
mentioned below:
• In case of deterioration of health condition, you may be moved from green to amber OR amber
to red category.
• Once you have been part of amber/red category, you will have to be part of the respective
category for a consecutive period of 2 years. Post the successful completion of 2 years in the
360 wellbeing program, your health condition will be reviewed by the health coach. On the
basis of the health condition at the time of review, it will be decided whether you need to
continue in the respective amber/red category or move to green category.

HOW TO EARN WELLNESS POINTS?

The earning and redemption of 360 Wellbeing points will occur through IL TakeCare App.
• Each wellness point is equivalent to 0.20 INR.

BE-HEALTHY POINTS
Be-Healthy points structure as per category.

POINTS
BLOOD TEST READING FREQUENCY TOTAL
EARNED/
POINTS
ACTIVITY

up to 5.99 750
Twice Maximum
HbA1c 6.00-6.50 300
a year 1500
6.51-7.00 100

110-120/70-80 750
Twice Maximum
Blood pressure 121-130/80-85 300
a year 1500
131-140/86-90 100

18.00 - 25.00 750

Twice Maximum
Body mass index 25.01 – 32.00 300
a year 1500
32.01 - 40 100

up to 150 mg/dl 750

Twice Maximum
Total cholesterol 151mg/dl-200mg/dl 300
a year 1500
201mg/dl-250mg/dl 100

Diagnostic test Preventive check up 300 300

Once
undergone a year
Self-paid advance check up 700 700

Total 7000
STAY HEALTHY POINTS
POINTS
TOTAL
PARAMETER CATEGORY DURATION FREQUENCY EARNED/ POINT
ACTIVITY
Advisory on health records Engagement Twice a year 2 400 800

Tele-consultation Engagement 4 times a year 4 150 600

Activity Tracking Activity Monthly 12 100 1200

Fitness challenge Engagement Twice a year 2 300 600

Sleep tracking Activity Monthly 12 100 1200

Once in
Health events Engagement 6 100 600
2 months
Advisory on health records Engagement 1000
Total 6000

Redemption of 360 wellness points (Stay-Healthy+ Be-Healthy) Points:

• The 360 Wellbeing points accrued by You can be redeemed against premium discount at
renewal, payment against non-payable items, OPD expenses, for payment of membership fees
in Fitness centers & health supplements as available on ICICI Lombard platform as per the
policy wordings.

FRESH 1st 2nd 3rd 4th

Renewal Renewal Renewal Renewal

Particulars 1st Year 2nd Year 3rd Year 4th Year 5th Year

Be-Healthy points illustration

Maximum points earned under

A 7000 7000 7000 7000 7000
Be-Healthy

Maximum points that can be

B 5500 5500 6000 6500 7000
redeemed

Balance point that can

C A-B 1500 1500 1000 500 0
be carried forward

3000 4000 4500 3000

Balance Points Balance Points of Balance Points of 4th
D Total Cumulative Balance Points 1500 Of 2nd year (C2) 3rd year (C3) + year (C4) + Carry
Carry forward points of
4th year (D4) – Balance
+ Carry forward Carry forward points forward points
points of 1st year(C1)
Points of 1st year (D1) of 2nd year (D2) of 3nd year (D3)

E Value of one 360 wellbeing point 0.2 0.21 0.22 0.23 0.25

Value in terms of INR for point that

F 1100 1155 1320 1495 1750
can be availed for benefit as per terms

Cumulative INR for carry

G D*E 300 630 880 1035 750
forward points
 FRESH 1st 2nd 3rd 4th

Stay-fit points illustration

Maximum points earned under

H 6000 6000 6000 6000 6000
Stay-Healthy

Maximum points that can be

I 5000 5000 5500 5500 6000
redeemed the same year

Balance point that can be carried

J I-J 1000 1000 500 500 0
forward

2000 2500 3000 2000

Balance Points Of 2nd Balance Points Of 3rd Balance Points Of 4th Carry forward points
K Total Cumulative Balance Points 1000 year (J2) + Carry year (J3) + Carry forward year (J4) + Carry of 4th year (K4)
forward Points of Points of 2nd year (K2) forward Points – Balance points
1st year (K1) of 3rd year (K3) of 1st year(J1)

L Value of one 360 wellbeing point 0.2 0.21 0.22 0.23 0.25

Value in terms of INR for point that

I*L 1000 1050 1210 1265 1500
M can be availed towards redemption
as per terms

Cumulative INR for carry

N K*L 200 420 550 690 500
forward points
*As the balance wellbeing points can be carried forward maximum up to 3 years, after three years they will become zero.

Terms and conditions for 360 wellbeing identify treatment for a medical or mental
program: health condition
• For health risk assessment [HRA] services • The 360 Wellbeing Points earned by you
availed through mobile application/ online/ through the 360 Wellbeing Program can be
digital mode on IL Platform, you will be carried forward for a maximum of 3 years
required to provide the details in order to and shall have to be redeemed at the end of
establish authenticity and validity prior to the 3rd Policy Year. In case, you does not
availing such services. Any such wish to redeem the wellbeing points earned,
information provided by the you in this the same will be forfeited
regard shall be used solely for the purpose
of providing these wellbeing services and
kept confidential with Us/ Our Network • There shall not be any cash reimbursement
Providers/ Health Service Providers at all or redemption available against the
times wellbeing points accumulated by an
Insured Person
• You shall notify us and submit the relevant
documents, reports, receipts as and when • In case of expiry of policy, the wellness
required by us within 60 days of points may be carried forward for a period
undertaking any wellbeing activity not exceeding three months
• You agree that choosing to utilize any of the
wellbeing services or any information or • The points accrued shall be at periodic
advise rendered by Our Health Service intervals at rates/amounts declared upfront
Providers or Network Providers or Us will be at the commencement of the policy and shall
solely at your own discretion and own risk not be linked to any dynamic factor such as
and should not be, used to diagnose or interest rate
• All the communication related to the respective directors, officers, employees,
360-wellbeing program point accrued, its agents, vendors, shall not be responsible
redemption and associated reminders will for or liable for, any actions, claims,
be through the IL take care application demands, losses, damages, costs, charges
and expenses which you may claim to have
suffered, sustained or incurred, as a result
• We or Our Health Service Providers or Our of any advice or information obtained by
Network Providers do not warrant the way of the wellbeing program or any
validity, accuracy, completeness, safety, actions chosen by you on the basis of such
quality, or applicability of the content or advice or information
anything said or written, or any suggestions
provided while providing the wellbeing
services • The 360-wellbeing program offered is
subject to revisions based on the insurance
regulatory framework from time to time
• We, our group entities, or affiliates, their
 CLAIM PROCESS
HOW TO INTIMATE A CLAIM?
Reach us at:

18002666
Monday to Saturday between 8:00 am to 8:00 pm

customersupport@icicilombard.com

IL TakeCare app

CASHLESS CLAIMS
• Get admitted in any one of our network hospitals
CLAIM PROCESS

• Reach out to insurance desk in hospital and submit the pre-authorisation

claim form along with relevant documents
• Hospital insurance desk shares the pre-authorization documents with IL
Health Care
• ICICI Lombard Health Care reviews your claim requested and accordingly
will approve, query, or reject the same (as per policy terms and conditions)

REIMBURSEMENT CLAIMS
If hospitalisation occurs in a non-network hospital:
• Upon discharge, pay all hospital bills and collect all original documents of
treatments and expenses underdone
• Send the duly filled (and signed by insured and treating doctor) claim form
and required claim documents
• ICICI Lombard Health Care will review your requested claim and will
accordingly approve, query, or reject the same (as per policy terms and
conditions)
• ICICI Lombard Health Care Settles the claim (as per policy terms and
conditions) and reimburses the approved amount

Below are the places from where you can download the claim form.

IL TakeCare App

ICICI Lombard Website

ICICI Lombard customer support helpline – 18002666

 HEALTH INSURANCE FAQ
1. Why do I need Health Insurance?
Healthcare is expensive. Technological advances, new procedures and more
effective medicines have driven up the cost of healthcare. This increase has to
FREQUENTLY ASKED QUESTIONS.

be borne by the consumer, making treatment unaffordable for too many. Health
Insurance overcomes these obstacles so that you remain free of anxiety
regarding your health. Think for a moment about the enormous medical costs
you would incur if you suffered a major accident tomorrow or were suddenly
stricken by an illness. Uninsured people live with such risks every day. Health
insurance seeks to shield you from that risk. It provides the much needed
financial relief. You also get tax benefit under section 80D of the Income Tax
Act and amendments made thereto.
2. How will health insurance pay for my emergency medical expenses?
Your health insurance will either pay your hospital bills directly if opted for the
cashless facility or it will reimburse any payment made by you towards medical
expenses incurred due to an illness or injury as per the policy terms.
3. What do you mean by Family Floater Policy?
Family Floater is one single policy that takes care of the hospitalisation
expenses of your entire family. The policy has one single sum insured, which
can be utilized by any/ all insured persons in any proportion or amount subject
to maximum of overall limit of the policy sum insured, as per policy terms and
conditions.
4. Will my health insurance cover begin from day one?
When you get a new policy, there will be a 30 days waiting period starting from
the policy inception date, during which period any hospitalisation charges will
not be payable by the insurance companies. However, this is not applicable to
any emergency hospitalisation occurring due to an accident. This waiting
period will not be applicable for subsequent policies under renewal.
Furthermore, in case of a declared pre-existing disease, a waiting period of 12
months will be applicable and certain specified diseases shall have a waiting
period of 24 months.
5. What is pre-existing condition in health insurance policy?
It is a medical condition/ disease that existed before you obtained health
insurance policy
6. If my policy is not renewed in time before expiry date, will it be denied
for renewal?
The policy will be renewable provided you pay the premium within 30 days
(called as Grace Period) of expiry date. However, coverage would not be
available for the period for which no premium is received by Us. The policy will
lapse if the premium is not paid within the grace period.
7. What happens to the policy coverage after a claim is filed?
After a claim is filed and settled, the Policy Sum Insured is reduced by the
amount that has been paid out on settlement.
For Example: In January you start a policy with a coverage of Rs. 5 Lakh for the year. In April, you make a
claim of Rs. 2 Lakh. The coverage available to you for the May to December will be the balance of Rs.3
Lakh.
 8. What is Unlimited Reset Benefit?
It is a benefit that allows an insured to reinstate the entire sum insured in the
policy year when it is insufficient as a result of previous claims in that policy
FREQUENTLY ASKED QUESTIONS.

year. In case the entire cover is exhausted, it gets replenished automatically for
the next hospitalisation that occurs within the policy year. Reset will not trigger
on first claim and cannot be used by same person for same illness for which
the claim has already been paid in the policy.
9. Does my policy offer worldwide cover?
On the basis of the plan selected, Health Shield 360 Insurance policy covers
Hospitalisation expenses (including planned hospitalisation) incurred abroad
as well.
10. What is covered under Domiciliary Hospitalisation?
Domiciliary Hospitalisation offers coverage for medical expenses in a
situation where the Insured Person is in such a state that he/she cannot be
moved to a hospital or the treatment is taken at home if there's a
non-availability of room in the hospital.
11. What is Super No Claim Bonus?
In case the customer has opted for this additional cover with extra premium,
there will be a 50% bonus awarded for every claim free year subject to a
maximum of 100%.
12. What is the maximum Sum Insured under the new plans?
All plans come with multiple Sum Insured options up to a maximum of 100
Lakhs.
13. Can I increase my Sum Insured at the time of renewal?
Yes, you can increase the Sum Insured at the time of renewal. However, fresh
waiting period would apply for the enhanced Sum Insured.
 HEALTH SHIELD 360 HEALTH SHIELD 360

HEALTH SHIELD 360

HEALTH SHIELD 360
HEALTH SHIELD 360
HEALTH SHIELD 360 HEALTH SHIELD 360
HEALTH SHIELD 360 HEALTH SHIELD 360
HEALTH SHIELD 360 HEALTH SHIELD 360

1)Prohibition of Rebates – Section 41 of the Insurance Act, 1938 1) No person shall allow or offer to allow either directly or indirectly as an inducement to any person to take out or
renew or continue an insurance in respect of any kind of risk relating to lives or property in India any rebate of the whole or part of the commission payable or any rebate of the premium
shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published
prospectus or tables of the insurer. 2) If any person shall fail to comply with sub regulation (1) above, he shall be liable to payment of fine which may extend to rupees ten lakhs. Only
for the customers of YES Bank Limited who wish to avail Health Shield 360 Insurance. Master Policy No. (4177i/MSTR/233939472/00/000) from ICICI Lombard GIC Ltd.The advertisement
contains only an indication of cover offered. For more details on risk factors, terms, conditions and exclusions, please read the sales brochure / policy wordings carefully before
concluding a sale. ICICI trade logo displayed above belongs to ICICI Bank and is used by ICICI Lombard GIC Ltd. under license and Lombard logo belongs to ICICI Lombard GIC Ltd.
ICICI Lombard General Insurance Company Limited, ICICI Lombard House, 414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025. IRDA Reg No.115 Toll Free 18002666, Fax No 022
61961323 CIN L67200MH2000PLC129408. Website : www.icicilombard.com Email: customerssupport@icicilombard.com.Product Name: Health Shield 360 UIN:
ICIHLGP22083V022122. ADV/13993