ICICI Lombard Health Insurance Claim Settlement
Founded in the year 2001, ICICI Lombard Health Insurance is one of the top general insurance providers in India. The company has settled over 3.6 million claims and with a claim settlement ratio of 99.7% in FY 2023, ICICI Lombard proves to be a dedicated and customer-centric company. This page covers all the details you should know about the claim settlement ratio, its importance, how to file a claim through ICICI Lombard health insurance, how to check your claim status and essential contact details. [1]
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Claim settlement Ratio of ICICI Lombard Health Insurance
The claim settlement ratio of ICICI Lombard Health Insurance is calculated by dividing total claims paid in a period of 30 days by the overall sum of claims paid. The claim settlement ratio or CSR of ICICI Lombard Health Insurance for the past 5 years are listed below [2]:
Why is Claim Settlement Ratio Important?
A company’s claim settlement ratio (CSR) is a strong and reliable insurance metric that helps you in choosing the right health insurance company for you and your loved ones. Two major reason why claim settlement ratio is important are listed below:
Helps in Assessing Insurer: While purchasing a policy, CSR is a performance metric that can help you gauge if an insurer is right for you. You must look at the CSR and compare them against the CSR of other companies that you may be exploring before the purchase. The higher an insurer’s claim settlement ratio is, the better are your chances of getting a claim.
Showcases Percentage of Claims Paid by the Insurer: A strong claim settlement ratio helps in understanding that the insurer pays claims at the time of need to the insured. However, at times claims get rejected when the appropriate documentation is not submitted, this also results in lowering a company’s claim settlement ratio.
ICICI Lombard Health Insurance Claim Initiation
To file a claim from ICICI Lombard Health Insurance follow the process mentioned below:
How to File a Claim
Step 1: Initiation
As soon as your medical appointment is made or an emergency occurs, contact the customer support team of InsuranceDekho or ICICI Lombard Health.
You can call an ICICI Lombard customer care team on their toll free number 1800 2666 or send an SMS ‘HEALTHCALIM’ to 575758 (there is an SMS charge of INR 3 per SMS). You can also email their customer care team at ihealthcare@icicilombard.com
To connect with an InsuranceDekho executive call on the customer support number 7551196989 or email us at support@insurancedekho.com
Step 2: Verification
Once your claim documents are submitted, ICICI Lombard’s claim team will verify all your documents. If everything is fine, your claim will be processed further.
Step 3: Tracking
For tracking your claim, you can check your ICICI Lombard app or connect with their customer care. You can also connect with an InsuranceDekho customer assistant to help you in getting regular updates.
Details to be Filled in the ICICI Lombard Health Claim Form
The details to be filled in the claim process for ICICI Lombard Health Insurance are divided in two parts. The segregated details are mentioned below:
Additionally, the below-mentioned details are also required:
Duly filled claim form
Discharge or daycare summary
Final hospital bill
Payment receipts
Investigation report
Pharmacy bills
Implant invoice
Doctor Prescriptions
Consultation Papers
Age Proof
Indoor Case Paper
Copy of cancelled cheque
KYC Form
Claim Process of ICICI Lombard Health
ICICI Lombard's Cashless Everywhere feature enables you to receive cashless treatments at any hospital within India, including those outside the network, subject to specific terms and conditions. For treatments at non-network hospitals, it's essential to notify ICICI Lombard within 48 hours in advance for planned procedures and within 48 hours in case of emergencies. Please be aware that obtaining approval for cashless treatment at non-network hospitals is contingent upon the terms and conditions outlined in your ICICI Lombard health insurance policy and agreements with the hospital.
Additionally, below are the steps to follow in case of cashless and reimbursement claims:
Cashless
Visit the nearest hospital
Go to the front desk and meet the third-party administrator or TPA
TPA will fill and submit your form on your behalf to ICICI Lombard health insurance
The claim executive will review the reports and process the claim if everything gets approved
Once you have the approval, you can take treatment at the hospital
Post-treatment, the bill will be settled directly between your insurer and the hospital
Reimbursement
Inform ICICI Lombard about your hospitalisation (48 hours before in case of planned hospitalisation and within 48 hours in case of emergency).
Clear your bills at the hospital and submit all documents.
Fill out and submit claim form
Wait for approval and status update from the insurer
Note that you need to submit all documents within 15 days of discharge along with your claim form keep all duly signed documents for submission for a smooth claim process
How to check the ICICI Lombard Health Insurance Claim Status?
To check the claim status of ICICI Lombard health, follow the steps mentioned below for both online and offline [4]:
Online
Visit the official website of ICICI Lombard Health Insurance
Go to the health insurance page and click on the “claims” link which will redirect you to the claim page
Choose “retail user” from the two options suggested - retail or corporate
Enter your claim number and select “Proceed”
Now your real time claim status will be displayed on the screen
Offline
Visit your nearest ICICI Lombard branch and carry the copy of your policy document with you
Connect with an executive at the branch office who will understand your policy and claim status and then assist you
Alternatively, you can also call on the toll-free number 1800 2666 or from the list of numbers mentioned on ICICI’s website, share your claim reference number with the customer care executive, and get the update.
ICICI Lombard Health Insurance Claim Settlement Time
According to the Insurance Regulatory and Development Authority of India (IRDAI), any insurer takes about 30 days from the date of reimbursement or claim document submission for claim settlement. [5]
Tips to Get Your Claim Settlement Faster
In order to get your claims settled faster, here are some points to keep in mind:
Understand your policy better
Submit completed documents only
Document everything you communicate with your insurer
Have an active policy
Carefully review all your documents
Seek the help of an attorney if required
ICICI Lombard Health Insurance Claim Assistance & Support
To get claim assistance and support from ICICI Lombard:
Call on toll free at 1800 2666
Email at ihealthcare@icicilombard.com
Connect through the IL TakeCare app
Whatsapp ICICI Lombard on by saying 'Hi' at 7738282666
To get claim assistance and support from InsuranceDekho you can:
Email at support@insurancedekho.com
Call on +91-755 1196 989.
References
https://www.insurancedekho.com/health-insurance/icici-lombard
https://www.icicilombard.com/claim-settlement-ratio
https://www.icicilombard.com/blogs/health-insurance/hi/how--to-ensure-your-reimbursement-claim-on-health-insurance-is-processed-smoothly
https://www.icicilombard.com/blogs/health-insurance/hi/how-to-check-health-insurance-policy-status
https://irdai.gov.in/health-dept
FAQs
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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.