ICICI Lombard Health Insurance Claim Settlement Ratio

ICICI Lombard General Insurance Company provides convenient and timely settlement of claims for their health insurance plans. The health claim settlement ratio of 78.32% seems satisfactory. The claim ratio determines the insurer’s ability to settle claims against the claim requests received. The plans are designed to keep you and your family healthy and happy, with an in-house claim processing and wellness center for smooth claim settlement without third-party intervention. Read more to know more about the ICICI Lombard claim procedure for cashless treatment and reimbursement of healthcare expenses during the policy term.

Claim Process of ICICI Lombard Health Insurance

ICICI Lombard has an in-house claim settlement team and wellness center. This saves your time in running from pillar to post. So, you can file a claim in two ways and the procedure for both of them is described below-

Claim Procedure for Cashless Hospitalization 

  • Visit one of the registered hospitals for treatment and go to the health desk and display the ICICI health card
  • A pre-authorization request form will be submitted to ICICI Lombard General Insurance on your behalf
  • ICICI Lombard General Insurance will approve your claim based on the verification
  • Once approval is received, cashless treatment will begin at the network hospital 
  • ICICI Lombard will pay-off the medical bills on your behalf
  • If the claim is rejected, you can continue the treatment but you will have to pay the bills and lodge a claim for reimbursement post-discharge

Claim Procedure for Reimbursement of Hospitalization Expenses

  • When getting discharged from the hospital, you have to collect the original copies of all the documents. Submit the claim and all the documents to ICICI Lombard General Insurance to recompense your medical bills
  • Your claim will be settled within fifteen days of submitting all the required documents
  • ICICI Lombard medical insurance claim will be rejected or approved based on the policy wordings

Documents Required for ICICI Lombard Health Insurance

Submit the following documents when filing a claim with ICICI Lombard-

  • Sign the claim form and get it signed from the treating doctor as well
  • Payment ​receipts from the hospital
  • Hospital discharge summary (along with the details of the treatment)
  • Consultation papers from the doctor
  • Detailed ​hospital ​bill (final & interim both)
  • 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 (in case of cataract surgeries lens details are required, in case of cataract stent details are required)
  • FIR report/ Medico ​legal ​certificate (MLC)  ( applicable to accidental cases only)
  • Copy of ​ICICI Lombard health insurance card
  • Other documents ( as per the case)

*Submit the original copies of all the documents.

FAQs

Written By: PolicyBazaar - Updated: 01 April 2021

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