ICICI Lombard Health Insurance Claim Settlement Ratio, Process, Form

ICICI Lombard Health Insurance Claim Settlement Ratio

ICICI Lombard General Insurance Company provides timely settlement of claims for their health insurance plans through an in-house Claims Management Team. As a result, the insurer earned an ICICI Lombard health insurance claim settlement ratio of 88.5% in FY 2021-22. The claim settlement ratio (CSR) determines the insurer’s ability to settle claims against the total claim received in a year. Hence, the CSR mentioned above indicates that the ICICI Lombard General Insurance Company paid 88.5% of the total claims received in the financial year of 2021-22.

Claim Process of ICICI Lombard Health Insurance Plans

The claim process of ICICI Lombard General Insurance Company is quite simple and convenient. In fact, policyholders can file an ICICI Lombard health insurance claim in two ways – cashless claims and reimbursement claims. The procedure to file a claim through both methods is described below:

Cashless Claim Procedure:

Here is the step-by-step procedure to file a cashless claim with ICICI Lombard health insurance:

Step 1: Inform the Insurance Company

Intimate ICICI Lombard General Insurance Company about your planned hospitalization at least 48 hours in advance. For emergency hospitalizations, inform the insurer within 24 hours of getting admitted.

Step 2: Get Hospitalized

Get admitted to any hospital of your choice and display the ICICI health card

Step 3: Submit Pre-Authorization Form

A pre-authorization request form should be submitted to the ICICI Lombard General Insurance Company along with other requested documents.

Step 4: Cashless Claim Approval

The ICICI Lombard Claims Management Team will verify your documents and will, accordingly, approve or reject your claim.

Step 5: Settlement of Claims

Once the approval is received, obtain the treatment and pay the bills that are not covered by the insurer during discharge. The ICICI Lombard General Insurance Company will pay all the remaining medical bills directly to the hospital.

Reimbursement Claim Procedure:

Take a look at the process to file a reimbursement claim with ICICI Lombard health insurance:

Step 1: Intimate the Insurer

Inform the ICICI Lombard General Insurance Company about your emergency hospitalization within 24 hours of getting admitted. In case of planned hospitalizations, the insurer must be informed at least 48 hours before hospital admission.

Step 2: Obtain Treatment and Pay the Bills

Obtain treatment at the hospital and pay all the bills at the time of discharge. Make sure to collect the original copies of all the medical documents before leaving the hospital.

Step 3: Document Submission

Submit all the required documents, including the ICICI Lombard health insurance claim form, to the insurance company.

Step 4: Claim Settlement

The ICICI Lombard Claims Management Team will review the documents and pay you the claim amount within the stipulated time period.

Documents Required for ICICI Lombard Health Insurance Claims

Submit the following documents to file a health insurance claim with ICICI Lombard General Insurance Company-

Duly signed health insurance claim form
Government ID proof
Hospital discharge summary (along with the details of the treatment)
Consultation papers from the doctor
Detailed hospital bill (final & interim both) with payment receipts
Chemist bills with doctor's prescription
All the original investigation reports (X-ray reports, blood reports, MRI scan reports, etc.)
Detailed bills are required to ascertain the miscellaneous charges
Implant invoice/sticker
Indoor case papers
FIR report/ Medico legal certificate (MLC) (Applicable to accidental cases only)
Copy of ICICI Lombard health insurance card
Duly filled KYC and NEFT forms
Copy of the cancelled cheque

FAQs

Q1. How are ICICI Lombard health insurance claim services?

Ans: ICICI Lombard General Insurance Company provides speedy and hassle-free claim services. The company has an in-house Claims Management Team that boasts of approving all cashless claims within 4 hours of filing the claim.
Q2. What is the time limit for the ICICI Lombard health insurance claim?

Ans: While all cashless claims of ICICI Lombard health insurance are settled within 4 hours, reimbursement claims are raised within 15 days of submitting the documents.

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Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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