ICICI Lombard Health Insurance Claim Settlement
ICICI Lombard Health Insurance provides you with an easy and convenient process to get claims settled. With a bouquet of health products to keep you and your family healthy and happy, the insurer maintains an in-house claim processing and wellness center to ensure a worry-free claim settlement without the intervention of a third party. There are two different scenarios for the claim process for ICICI Lombard, cashless and reimbursement process.
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Claim Process for Cashless Treatment
The cashless claim process can be availed during treatment at a network hospital. Currently, ICICI Lombard has more than 3,600 network hospitals across the country for cashless treatment. The steps in the cashless claim process are as follows:
- Look for an ICICI Lombard Health Insurance network hospital in your area.
- Intimate the insurer about the admission - for emergency hospitalisation within 24 hours and for planned hospitalisation 1-2 days prior.
- While visiting the hospital, carry your ICICI Lombard health ID card and one valid photo ID.
- Show the ICICI Lombard health ID card to the hospital help desk executive.
- Fill in the pre-authorisation form provided by the hospital and submit it.
- After your identity is checked, the hospital sends the pre-authorization request form to ICICI Lombard.
- Once ICICI Lombard reviews the documents, it either approves or disapproves the claim.
- Upon approval, you can proceed with the cashless treatment, and all the bills are directly settled by ICICI Lombard.
- In case of rejection, you can get the treatment at the hospital and pay all hospital bills out of your pocket.
How to Check ICICI Lombard Health Insurance Plan Claim Status
You can check the status of your claim settlement either online or offline.
Online Procedure
To check the claim status online follow the below-given steps:
- Visit the official website of ICICI Lombard and go to their claim status portal.
- Enter the required details such as Claim No or AL No and click on ‘Search’.
- Thereafter, you can check the status of your claim on the displayed web page.
Offline Procedure
To check the status of your claim through offline mode, simply call the customer care representatives at 1800 2666( Toll Free Number) or you can even visit their nearest branch and ask the customer care representative for help regarding the same.
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Reimbursement Treatment
Reimbursement claims can be made during treatment at a network or non-network hospital. The steps for the reimbursement claim process are as follows:
- Intimate ICICI Lombard Health Insurance within 24 (emergency hospitalisation) and before 1 or s days before admission in case of planned hospitalisation.
- Also, let the insurer know about hospital admission.
- Get treatment at the hospital.
- At the time of the discharge, collect all original documents from the hospital.
- Submit these documents along with the duly filled and signed Reimbursement claim form at the nearest ICICI Lombard Health Insurance branch.
- Within 15 days of receipt of all the documents, ICICI Lombard will settle the claim amount.
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Documents Needed
Here is a list of documents required for filing a reimbursement claim.
- Original investigation reports
- Final hospital discharge summary
- FIR or post-mortem report it happened
- Pharmacy bills along with the prescription
- Canceled cheque or NEFT details for payment
- Original bills, receipts, and discharge report
- Indoor case papers and duly filled claim form
- Original hospital bills and a valid photo ID proof
- Treating doctor's report, and original consultation notes
- Nature of operation performed and surgeon's bill and receipt
- Test reports along with attending doctor’s or surgeon’s report
In case of any query, you can call the toll-free number of InsuranceDekho i.e. 7551-196-989.
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Incurred Claim Ratio (ICR) of ICICI Lombard Health Insurance
The Incurred Claims Ratio (ICR) of ICICI Lombard clearly indicates its customer-centric presence in health insurance. The ICICI Lombard Health Insurance Claim Settlement ratio for FY 2018-19 is 76%. An insurance company with more than 50% ICR is considered reliable.
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FAQs
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What are the different claim settlement options offered by ICICI Lombard Insurance?
ICICI Lombard Insurance offers cashless, and reimbursement claims. In case of emergency treatments, cashless claims are provided if the insurer is informed within 24 hours of hospitalisation and in any other cases a 48-hour notice before hospitalisation is required by the insurer.
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How long does it take for ICICI Lombard Insurance to settle a claim?
Settlement of a claim is made within 15 days by ICICI Lombard Health Insurance.
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What documents are required to file a claim with ICICI Lombard Insurance?
The following documents are required while filing a claim are, original investigation report, final hospital discharge summary, FIR or post-mortem report (if happened), pharmacy bills and prescriptions, cancelled cheque or NEFT details for payment, original bills, receipts, indoor case paper, and duly filled claim settlement form, treating doctor’s reports, consultation reports, nature of operation performed, surgeon’s bills and receipts and test reports along with assisted doctor’s report.
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What steps should I take if my claim with ICICI Lombard Insurance is denied or delayed?
Reach out to an InsuranceDekho advisor for any problem due to claim denial or rejection. The advisor will help you resolve the problem.