ICICI Lombard Health Insurance Claim Settlement

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]:

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:

1. 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.

2. 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.

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:

1. Duly filled claim form

2. Discharge or daycare summary

3. Final hospital bill

4. Payment receipts

5. Investigation report

6. Pharmacy bills

7. Implant invoice

8. Doctor Prescriptions

9. Consultation Papers

10. Age Proof

11. Indoor Case Paper

12. Copy of cancelled cheque

13. KYC Form

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

1. Visit the nearest hospital

2. Go to the front desk and meet the third-party administrator or TPA

3. TPA will fill and submit your form on your behalf to ICICI Lombard health insurance

4. The claim executive will review the reports and process the claim if everything gets approved

5. Once you have the approval, you can take treatment at the hospital

6. Post-treatment, the bill will be settled directly between your insurer and the hospital

Reimbursement

1. Inform ICICI Lombard about your hospitalisation (48 hours before in case of planned hospitalisation and within 48 hours in case of emergency).

2. Clear your bills at the hospital and submit all documents.

3. Fill out and submit claim form

4. 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

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.

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:

1. Understand your policy better

2. Submit completed documents only

3. Document everything you communicate with your insurer

4. Have an active policy

5. Carefully review all your documents

6. Seek the help of an attorney if required

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

1. https://www.insurancedekho.com/health-insurance/icici-lombard

2. https://www.icicilombard.com/claim-settlement-ratio

3. https://www.icicilombard.com/blogs/health-insurance/hi/how--to-ensure-your-reimbursement-claim-on-health-insurance-is-processed-smoothly

4. https://www.icicilombard.com/blogs/health-insurance/hi/how-to-check-health-insurance-policy-status

5. https://irdai.gov.in/health-dept