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ICICI Lombard Health Insurance Claim Settlement

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Highlights
Cashless Approval TAT2 hr Cashless Claim Processing
Claim Settlement Ratio99.70%
Network Hospitals7,500+
Pre-existing Disease Waiting Period2 year
Special BenefitsAnywhere Cashless
Starting Premium for Rs. 5 lakh SIRs. 581/month

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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.

    How to Check ICICI Lombard Health Insurance Plan Claim Status

    You can check the status of your claim 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 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 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 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 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. Incurred Claims Ratio of ICICI Lombard Health Insurance for FY 2018-19 is 76%. An insurance company with more than 50% ICR is considered reliable.

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ICICI Lombard Health Insurance User Reviews

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  • Impressive services are offered by InsuranceDekho. My ICICI Lombard Health Insurance Policy was renewed withou...

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    By Rintoo Bhatia
    On: Jul 06, 2023
  • I would like to thank InsuranceDekho for advising me for buying the ICICI Lombard Health Insurance Policy. Thi...

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    On: Jun 23, 2023
  • The best part about InsurancedDekho and its policies are that they are very transparent The pricing and terms ...

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    By Yuvan Bhatia
    On: Jun 12, 2023
  • I found the ICICI Lombard Health Insurance Policy offered by InsuranceDekho to be great value for money. The c...

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    ICICI Lombard
    By Seema Bandi
    On: Jun 05, 2023
  • The ICICI Lombard Health Insurance Policy offered by InsuarnceDekho has the availability of flexible add-on op...

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    ICICI Lombard
    By Priyanka Ghosh
    On: May 30, 2023
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ICICI Lombard Health Insurance Contact Details

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Claim Process at ICICI Lombard Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 1-2 days prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 1-2 days prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

1573 ICICI Lombard Cashless Network Hospitals in India

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ICICI Lombard Health Insurance Claim Settlement FAQs

  • What is a cashless claim?

    A cashless claim means you need not to pay to the hospital even a single penny from your pocket. You can file for a cashless claim if you avail treatment at a network hospital. You can avail the cashless claim during treatment at a network hospital. 

  • What are the documents required for claim settlement process at ICICI Lombard?

    The list of documents includes claim form, original hospital bills, discharge summary, original discharge report, other reports like medicine bills along with a prescription, attending physician’s reports, diagnostic and test reports, surgeon’s reports, etc. and follow-up checkup reports if any.  

  • How can I file a cashless claim with ICICI Lombard?

    To file a cashless claim, intimidate the insurer about admission, get admitted at a network hospital, show your ID card at the hospital desk, fill in the pre-authorisation form and submit it. Once your application is approved, you can proceed with the cashless treatment and all bills will be directly settled by ICICI Lombard.  For more details, call InsuranceDekho at 7551-196-989. 

  • Does ICICI Lombard offer reimbursement claim facility?

    Yes, ICICI Lombard offers a reimbursement claim facility. To get this claim, call the insurer at 1800-2666, get treatment at any hospital, collect all original documents from the hospital and send them to ICICI Lombard. Within 15 days of receipt of all the relevant documents, ICICI Lombard will settle the claim amount. For details, dial the toll-free number of InusranceDekho, i.e. 7551-196-989. 

  • How to calculate the Claim Settlement Ratio (CSR) of ICICI Lombard Health Insurance?

    The Claim Settlement Ratio of ICICI Lombard Health Insurance can be calculated using the formula given below: 

    Claim Settlement Ratio = (Total no. of claims approved/Total no. of claims received) x 100

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