ICICI Lombard Claim Process

ICICI Lombard Health Insurance Claim Process

Claims are requests forwarded by a policyholder to their insurance provider, outlining details of medical treatment and seeking compensation. While filing a claim can seem daunting, insurance companies have developed platforms to make this process effortless.

ICICI Lombard has designed a user-friendly interface for its claim filing process, ensuring easy navigation for policyholders. Claims can be raised through the company’s website and mobile application. Let us see how to claim ICICI Lombard Health Insurance.

Modes to Report a Claim

Customers can register a claim in various ways for their convenience:

• Through Website: Access the official website at www.icicilombard.com and report a claim online.
• 24/7 Claim Care Number: The company has a dedicated phone number, 1800-2666, to register a claim.
• Email ID: Policyholders can send an email to [email protected] to notify the company of a claim.
• SMS: Customers can text 'HEALTHCLAIM' to 575758.
• Visit the Branch: Policyholders can visit the nearest branch to submit the claim offline along with the necessary documents.
• Mobile Application: Claims can also be raised through the company's mobile application, 'TakeCare App'.

Types of ICICI Lombard Health Insurance Claims

The ICICI Health Insurance claim process is categorized into two parts based on the nature of the claim and how the policyholder seeks compensation:

• Cashless Claims: This allows the policyholder to receive medical treatment without paying upfront. The company directly settles the medical bill with the network hospital.
• Reimbursement Claims: The ICICI Lombard Health Insurance reimbursement claim process involves the insured person paying the bill from their pocket at the time of discharge, and then later seeking compensation from the insurer.

How to Raise an ICICI Lombard Health Insurance Cashless Claim

Cashless claims can be complex; it is advisable to contact the TPA or the company’s customer care for assistance. Here is how it works:

1. Online Claim Intimation: Visit a network hospital. Inform ICICI Lombard about the hospitalization via email, call, or SMS. Remember to mention your Policy Number or Patient ID Number, found on your Cashless Identification Card.
2. Documentation: After treatment, submit all required documents along with the duly filled 'Pre-Authorization Form'. The doctor in charge of your treatment will complete specific sections of this form.
3. TPA Coordination: Mail or submit the documents to the TPA. The company will then verify your claim.

Important Points for Cashless Claims

• Contacting the TPA for cashless claims is recommended as they act as a bridge between the insurance company and the hospital.
• Inform the insurance provider 72 hours before a planned hospitalization.
• Inform the insurance company within 24 hours in case of emergency hospitalization.
• You can download the pre-authorization form from the official website of the company.
• It is best to fill out the pre-authorization form during treatment, as it requires the doctor's involvement. This will save you time and effort from revisiting the hospital later.

Documents Required for Cashless Claims

The TPA will guide you with the documents and coordinate with the hospital to complete all necessary information. Here is the list of documents required:

• Health Card
• Medical Reports
• Proposal Form
• Patient Discharge Summary
• Investigation Report
• FIR (If Required)
• Proof of Age
• Pre-Authorization Claim Form

ICICI Lombard Health Insurance Reimbursement Claim Process

This process gives the policyholder the freedom to receive treatment from any hospital, including those outside the network. Here is the process for reimbursement:

1. Inform the Company: The policyholder must inform the company about the hospitalization. They can call the toll-free number '1800-2666' or SMS 'HEALTHCLAIM' to '575758'. They can also submit the claim in writing by emailing '[email protected]'.
2. Documents: After receiving treatment and paying the hospital bills, arrange all documents in sequence, starting from the original bill, X-ray reports, medical expenses, discharge summary, and other hospital bills.
3. Fill and Submit the Claim Form: Next, download the claim form from the company's official website. Fill in all details in sections A, B, C, and D of the form. The doctor who administered the treatment must fill and sign Section B. After completing all sections, post the form along with the required documents. Your part of the process is then complete.

Post Address: ICICI Lombard Health Care, ICICI Bank Tower, Plot No 12, Financial District, Nanakramguda, Gachibowli, Hyderabad, 500032.

Important Points for Reimbursement Claims

• Submit the documents along with the claim form within 15 days of discharge from the hospital.
• Keep all documents signed and handy for smooth claim filing.
• Download the claim form from the official website of the company.

Documents Required for Reimbursement Claims

Keep all documents aligned before filing the claim. The list of documents is as follows:

• Duly Filled Claim Form
• Original Discharge Summary
• Original Final Hospital Bill
• Original Payment Receipt
• Original Investigation Reports
• Original Pharmacy Bills
• Original Implant Invoice
• Photocopy of Consultation Papers
• Photocopy of Age Proof
• Photocopy of Indoor Case Papers
• EFT (Cancelled Cheque/Self-Attested ID Proof)
• KYC documents