ICICI Lombard Health Insurance Claim Settlement

ICICI Lombard Health Insurance

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5,025+ Network Hospitals

42,34,760 Policies Issued

Lifelong Renewability

78.32% Claim Settlement Ratio

In-House Health Claim Process

Coronavirus (COVID-19) Cover

Claim Settlement of ICICI Lombard Health Insurance

ICICI Lombard 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 centre to ensure a worry-free claim settlement without intervention of a third party. There are two different scenarios for the claim process for ICICI Lombard, cashless and reimbursement process.

  • 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.
  • Reimbursement Treatment

    Reimbursement claim 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 duly filled and signed 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.
  • 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 if 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 toll free number  InsuranceDekho at 1800-120-5698.

  • 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. Incurred Claims Ratio of ICICI Lombard Health Insurance is 76%. An insurance company with more than 50% ICR is considered good.

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