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  1. ICICI Lombard clarification on the material change clause in health insurance policy: All you need to know

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ICICI Lombard clarification on the material change clause in health insurance policy: All you need to know

Upstox

2 min read | Updated on October 23, 2025, 12:22 IST

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SUMMARY

Material change clause asks you to tell the insurer about any new illnesses or medical conditions when you renew your policy

material change clause health insurance

ICICI Lombard clarified that you won’t have to go through fresh medical checks or pay higher premiums just because you renew your policy, as long as you stay healthy. | Image: Shutterstock

Health insurance policies often have something called a material change clause, which can be confusing for many people.

“There have been some misunderstandings online and in the media about the material change clause in our health plans, like Elevate and Health AdvantEdge.,” ICICI Lombard issued a clarification.
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"The material change clause does not mean your premiums or coverage will go up if you develop a new illness after your policy starts. ICICI Lombard follows all IRDAI rules and industry standards," the insurer said.

  • The material change clause and renewal clause are designed to work together in a way that benefits customers.

  • In fact, if your health improves, you might even get a reduction in premiums at renewal.

  • When you share your health details, it also helps us offer free health check-ups and wellness programs to keep you healthy.

  • You won’t need any fresh medical tests when renewing, unless you:

Increase your sum insured

Add new family members to your policy

Choose to include extra covers

The insurer said that it has never rejected a claim because of the Material Change Clause.

ICICI Lombard clarified that you won’t have to go through fresh medical checks or pay higher premiums just because you renew your policy, as long as you stay healthy. This means your premium or coverage won’t increase at renewal unless you choose to make changes.

What is the material change clause?

It asks you to tell the insurer about any new illnesses or medical conditions when you renew your policy. Based on this information, the company can adjust its coverage or premium if needed.

Some plans with this clause include:

ICICI Lombard Health AdvantEdge

SBI General Arogya Supreme

SBI General Health Edge

SBI General Super Health

Acko Retail Health

What does IRDAI say?
The Insurance Regulatory and Development Authority of India (IRDAI) clearly states that insurers cannot penalise you for new health changes when you renew your policy.
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Upstox
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