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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.

  • 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.

  • 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.
  • 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.

  • 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

  • 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.

  • 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.

  • 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.

  • 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.

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    I bought the ICICI Lombard Health Insurance Plan from their online platform. The insurance experts of the InsuranceDekho company explained all the policies available in detail. It was very easy for me to compare the health insurance plans and choose the best for myself. My heartful thanks to the InsuranceDekho company for helping me in buying the best health insurance plan.

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    By Rohit Kumar
    On: Mar 12, 2024
  • Excellent team support

    The team of InsuranceDekho provided me with the necessary information when I was buying the ICICI Health AdvantEdge plan with them. They helped me understand all about the plan in a better way

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    By Naksh Taneja
    On: Mar 01, 2024
  • The plan has amazing features

    The ICICI Lombard Health Insurance Plan available on InsuranceDekho has amazing features to offer. On InsuranceDekho’s website, I was able to check all the details about the ICICI Lombard Health Insurance plan on InsuranceDekho and understand its benefits. Thank you! InsuranceDekho for this amazing health insurance.

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    By Harsh Garg
    On: Mar 01, 2024
  • Great Assistance

    Great services are offered by InsuranceDekho. I bought the ICICI Lombard insurance policy from the company’s official website. The company's customer support team provided the best assistance to me in the process. I am thankful to customer service for making my process smooth and easy buying the ICICI Lombard Health insurance plan.

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    By Nishant Tiyagi
    On: Feb 01, 2024
  • Budget-Friendly Policies

    My policy purchasing experience from InsuranceDekho was smooth and convenient. Thanks to the supporting team from the company who helped me throughout the purchasing process. I thank to the insurance experts for suggesting  ICICI Lombard Health Insurance to me.

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    By Randeep Singh
    On: Dec 06, 2023

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