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 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.
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.