ICICI Lombard Claim Process
  • Modes of Reporting Claims
  • Cashless Claims
  • Reimbursement Claims
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Network hospitals

7500+

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Incurred claim ratio

77.33%

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Sum insured

Up to 1 CR

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No. of Plans

8

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Solvency Ratio

2.5

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Pan India Presence

300+

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Age of Eldest Member

premium

Network hospitals

7500+

premium

Incurred claim ratio

77.33%

premium

Sum insured

Up to 1 CR

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No. of Plans

8

premium

Solvency Ratio

2.5

premium

Pan India Presence

300+

ICICI Lombard Health Insurance Claim Process

Claims are the requests forwarded by the policyholder to the insurance providers, outlining the details of the medical treatment and seeking compensation for the same. Filing the claim can be a daunting task, but insurance companies have diligently crafted platforms to transform this tedious task into an effortless journey.

When speaking of the claim filing process ICICI Lombard has designed a user-friendly interface, ensuring the policyholder to navigate easily. The claim can be raised through the company's website and mobile application. Let us see how to claim ICICI Lombard Health Insurance.

Health Insurance Companies: Policy and Claim Process

Modes To Report The Claim: There are various ways a customer can register the claim. The various modes are designed to provide convenience to the customer:

  • Through Website: The customer can access the official website by going to www.icicilombard.com and report a claim on the website.
  • 24*7 Claim Care Number: To register a claim the company has a dedicated phone number. The Claim Care Number is 1800-2666.
  • Email ID: The policyholder can send an email to the company at ihealthcare@icicilombard.com to notify the claim.
  • SMS: The customer can even send an SMS to the service number of the company. They can text 'HEALTHCLAIM' on the number 575758.
  • Visit The Branch: The policyholder can visit the nearest branch and submit the claim offline along with the necessary documents.
  • Mobile Application: The claims can also be raised through mobile phones. The name of the mobile application of the company is'IL TakeCare App'

How To Claim ICICI Lombard Health Insurance

ICICI Health Insurance claim process can be categorized into two parts based on the nature of the claim and how the policyholder is seeking compensation. The types are:

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

How To Raise ICICI Lombard Health Insurance Cashless Claim:

Cashless claims can be challenging to complete on our own, it is better to contact the TPA or call the company's customer care number for assistance. Here is how it works:

Step 1: Online Claim Itimation

  • Visit the network hospital of the company. Inform the company about the hospitalization, through email, call, or SMS.
  • Please do mention the 'Policy Number or Patient ID Number', present on the 'Cashless Identification Card' of the company.

Step 2: Documentation

  • After the treatment, submit all the documents along with the duly filled 'Pre-Authorization Form'. There are sections in the form which is filled by the doctor who is in charge of the treatment.

Step 3: TPA

  • You can mail the documents or submit them to the TPA. Now wait for the company for verification.

Points To Be Noted:

  • Contacting the TPA for cashless claims is the best option because 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 the treatment, as it requires the involvement of the doctor. This will save you the time and effort of revisiting the hospital for the same procedure.

Documents Required For Cashless Form

TPA will guide you with the documents and will also coordinate with the hospital to complete all the information asked in the form. 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 Process

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

Step 1: Inform The Company

The policyholder has to inform the company about the hospitalization. They can call on the toll-free number '1800-2666' or SMS 'HEALTHCLAIM' at '575758'. They can even submit the claim in written form, by emailing at 'ihealthcare@icicilombard.com'.

Step 2: Documents

After receiving the treatment from the hospital and paying the bills. Place all the documents in sequence starting from the original bill, X-ray reports, medical expenses, discharge summary, and other hospital bills.

Step 2: Fill and Submit the Claim Form

Next, download the claim from the official website of the company. Fill in all the details in the A, B, C, and D sections of the claim form. The doctor who administered the treatment has to fill and sign Section B of the form. After completing all the sections post the form along with the required documents. Your contribution to the work is completed here.

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

Points to Be Noted:

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

Documents Required For Reimbursement Claims:

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

  • Duly Filled Claim Form
  • Original Discharge Bill
  • Original Final Hospital Bill
  • Original Payment Receipt
  • Original Investigation Report
  • Original Pharmacy Bills
  • Original Implant Invoice
  • Photocopy of the Consultation
  • Photocopy of Age Proof
  • Photocopy of Indoor Case paper
  • EFT (Cancelled Check/Self-Attested ID Proof)
  • KYC

ICICI Lombard Health Insurance Policy Online Renewal Process

Below mentioned are the steps that will help you to renew your health insurance policy online with ICICI Lombard General Insurance:

  • Visit the official website of ICICI Lombard General Insurance and click on the 'Renewal' from the top bar menu.
  • Select the 'Health Policy' tab and on the next page fill in all the required details such as policy number and date of birth.
  • Click on 'Proceed'. Next, if you want to make any modifications such as changing the sum insured amount, opting for an add-on, etc., you can do that while reviewing your policy details.
  • Make the payment online for the renewal fee from the available modes of payment.
  • Once the payment has been made, the policyholder will receive the policy details on their registered email address.

Explore more plans from ICICI Lombard

ICICI Lombard Insurance company offers several tailored health plans that are designed to serve you in the best way possible. Take a look:

A Top-up plan that offers extra coverage to you and your family with a comparatively lower premium with a policy deductible principle.

Unique Features

  • Wellness Programs
  • Critical Illnesses Covered
  • Lifetime Renewability available

Health Booster (Pros)

  • No Check-up up to 10 Lakh
  • Discount of up to 12.5%
  • Cashless treatment Hospitals
  • Reimbursement within 14 days
  • Deductible options (3/4/5 lakhs)

Health Booster (Cons)

  • No international Coverage
  • No Alcohol or drug abuse
  • No Refractive error correction
  • Dental treatment not covered
  • No hearing impairment correction

Health Booster (Other Benefits)

  • Hospital Daily Cash
  • Convalescence Benefit
  • Personal Accident Cover
  • Repatriation of Remains
  • (TTD) Rehabilitation Cover

Health Booster (Eligibility Criteria)

  • Entry Age - 18 Years
  • No Upper Age Limit
  • SI - 5 L to 50 L
  • Waiting Period - 30 Days

The plan offers personal accident coverage on an individual and family floater basis, with coverage up to 25Lakhs.

Unique Features

  • Permanent Disability Covered
  • No pre-medical required
  • Worldwide coverage

Personal Protect Plan (Pros)

  • All Disablement Covered
  • Accidental Hospital Allowance
  • Rail accidents covered
  • Natural Peril Injury CFovered
  • No health check-up required

Personal Protect Plan (Cons)

  • Change of Gender Treatments
  • Cosmetic or Plastic Surgery
  • Dental treatment not covered
  • Maternity expenses not covered
  • No Global Coverge

Personal Protect Plan (Other Benefits)

  • No Injuries in terrorism covered
  • Hospital Daily Allowance Benefit
  • Accidental Hospital Allowance
  • Funeral Expenses covered
  • Children's Education Grant Benefit

Personal Protect Plan (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 3 L to 25 L
  • Waiting Period - 30 Days

Corona Kavach Plan

A plan mandated by IRDAI that offers covers the hospitalization expenses if the insured is tested positive for Covid-19.

Unique Features

  • Flexible Sum Insured
  • Home-care treatment covered
  • Treatment for comorbid

Corona Kavach Plan (Pros)

  • Covid Hospitalization charges
  • Home Care Treatment Expenses
  • AYUSH Treatment Covered
  • Hospital Daily Cash
  • Flexible Policy Period

Corona Kavach Plan (Cons)

  • Dietary supplements expenses
  • Unproven Treatments expenses
  • Respite care not covered
  • Investigation Expenses
  • Rehabilitation not covered

Corona Kavach Plan (Other Benefits)

  • Inpatient hospitalization
  • Family Floater Benefit
  • In-patient treatment
  • Home care treatment
  • Post-hospitalisation

Corona Kavach Plan (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 50 Thousand to 5 L
  • Waiting Period - 15 Days

A senior citizen plan that covers medical expenses resulting from hospitalisation, health check-ups, day-care procedures and more.

Unique Features

  • Affordable Medical Care
  • Care Management Program
  • Reset Benefit

Golden Shield Plan (Pros)

  • Nursing at home
  • Free annual health check-ups
  • Air ambulance coverage
  • Tele consultations
  • AYUSH treatments

Golden Shield Plan (Cons)

  • Voluntary Deductible amount
  • Expenses Outside India
  • No Acupressure Treatments
  • 2-Year Waiting Period
  • Obesity/Weight Control treatment

Golden Shield Plan (Other Benefits)

  • Pharmacy Cover up to Rs 2,000
  • Out-patient consultations
  • Can update a family member
  • Routine Diagnostics covered
  • Minor Procedure Covered

Golden Shield Plan (Eligibility Criteria)

  • Entry Age - 56 Years
  • Max Age -No Upper age limit
  • SI - 3 L to 10 L
  • Waiting Period -24 Months

A comprehensive plan for you and your family covering

Unique Features

  • Swine Flu Treatment Covered
  • Pre Existing Disease Covered
  • Cumulative Bonus upto 50 %

Health AdvantEdge (Pros)

  • No health check-ups
  • Domestic Air Ambulance
  • 24x7 Customer Support
  • Newborn baby and vaccine cover
  • Health rewards

Health AdvantEdge (Cons)

  • No Non-allopathic Treatments
  • Unproven treatment not covered
  • HIV/AIDS treatments not covered
  • 3-Year Waiting Period
  • Obesity treatment not covered

Health AdvantEdge (Other Benefits)

  • Bariatric surgery cover
  • Maternity Expenses Covered
  • Orthopaedic Expenses Covered
  • Chemotherapy Covered
  • Eye Surgery Covered

Health AdvantEdge (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age -65 Years
  • SI - 2 L to 5 L
  • Waiting Period -30 Days

A standard Health plan that offers coverage up to 5 lakhs to the insured & his family. The plan offers you everything you need under a health insurance plan.

Unique Features

  • Cumulative Bonus
  • Cataract treatment covered
  • Modern Procedures covered

Arogya Sanjeevani Policy (Pros)

  • Intensive Cardiac Care Charges
  • Ambulance charges up to 2000
  • Cataract treatment
  • In-patient hospitalization
  • Uterine Artery Embolization

Arogya Sanjeevani Policy (Cons)

  • No Eyesight correction expenses
  • Fertility expenses not covered
  • Nursing at home not covered
  • OPD expenses not covered
  • No Non-allopathic Treatment

Arogya Sanjeevani Policy (Other Benefits)

  • Floater benefit
  • Pre-existing diseases after 4 yrs
  • In-patient AYUSH treatment
  • Daycare procedures
  • Pre and post-hospitalisation

Arogya Sanjeevani Policy (Eligibility Criteria)

  • Entry Age - 18 Years
  • Maximum Entry Age - 65 Years
  • SI - 1 L to 5 L
  • Waiting Period - 30 Days

ICICI Lombard Saral Suraksha Bima

A plan that offers coverage for accidental death and disablement, temporary total disablement and gives Education Grant.

Unique Features

  • 100% Death Benefit
  • Emergency Care
  • Cumulative Bonus up to 50 %

Saral Suraksha Bima (Pros)

  • 10% Education Grant
  • Temp. Total Disablement cover
  • In-Patient Care
  • Total Disablement cover
  • Partial Disablement cover

Saral Suraksha Bima (Cons)

  • Hazardous sports not covered
  • No Intentional self-injury cover
  • Alcoholism not covered
  • Injury due to violation of the law
  • Obesity treatment not covered

Saral Suraksha Bima (Other Benefits)

  • Plastic surgery after accident
  • Surgical Procedure after accident
  • 50% Cumulative Bonus
  • All Day Care Treatment
  • Dental Treatment after accident

Saral Suraksha Bima (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age -70 Years
  • SI - 2 L to 5 L
  • Waiting Period -30 Days

ICICI Lombard Claim Process: FAQ's

1. Does the claim registered over the phone qualify as a formal claim?

No, this mode is considered as verbal intimation and an informal mode of reporting a claim.

2. Which mode is considered to be the best way to register a formal intimation?

The claims will be formally registered only through the written request.

3. How can we get the pre-authorization from?

You can download the pre-authorization form from the official website of the company. Visit the website of ICICI Lombard Health Insurance, then click on the 'Downloads' section.

4. How can we get the claim form?

Claim forms can be downloaded from the 'Downloads' section on official website of ICICI Lombard Health Insurance.

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Simran Kaur Vij

Written By: Simran Kaur Vij

Simran is an insurance expert with more than 3 years of experience in the industry. She may have all the answers to your insurance queries. With a background in Banking, she proactively helps her readers to stay on par with all the latest Insurance industry developments.