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Choosing an ideal health plan is a tedious task, however, choosing an ideal health insurance company is more of a hectic task. With more than 20 health insurance companies claiming to offer you the best services, selecting the best one for you and your family can be quite confusing. So, one of the significant criteria to consider when choosing an insurance company from which to purchase insurance is the claim settlement ratio.

This factor not only helps you to understand the company's performance but will also smoothen the selection process. If the claims are not resolved, the entire point of purchasing insurance coverage is defeated. Thus, before zeroing down on your choice of one insurance company, it is important for you to check the company's claim settlement history.

In the section below, let us explore the ICICI Lombard Claim Settlement Ratio, and discuss its importance:

According to Claim statistics for FY 2021-22 and computed basis individual claims settled (paid) over total individual claims within 30 days the health insurance claim settlement ratio of ICICI Lombard is 97.07%.

Let us get a better understanding of the ICICI Lombard Claim Settlement Ratio

Health Insurance Claim Settlement Ratio

Types Of ICICI Lombard Health Insurance Claims

There are two types of health insurance claims you can choose from

  • Cashless Claim
  • Reimbursement Claim

Health Insurance Companies

What Are Cashless Claims?

Cashless claims in health insurance is a mode of claim settlement where the policy holder does not have to pay cash for treatment and the settlement of the bills is taken care of directly between the hospital and the insurance company. ICICI Lombard cashless claim settlement helps in paying off the hospital bill instantly, upfront. Cashless claims are gaining popularity every day, and more and more people getting health insurance policies are availing this feature for the comfort it offers.

Status of ICICI Lombard Health Insurance Claim Settlement Ratio - 2021-22

Financial Year 2021-22
Age Analysis of Number of Claims Paid (%) < 3 months 3 months to 6 months 6 months to <1 year 1 year to <3 year 3 years to <5 years 5 years
Claims Settled 97.07 1.69 0.59 0.37 0.12 0.17

Here’s How You Can File Your Cashless Claims Online

Step 1: Find the network hospitals of ICICI Lombard Health Insurance and get admitted to only those hospitals that fall into the network of your insurer.

Step 2: Now, notify ICICI Lombard Health Insurance Company about the hospitalization. In case of pre hospitalization inform the insurer about the hospitalization prior to getting admitted.

Step 3: The customer needs to fill the pre authorization form and submit it to the hospital. The pre-authorization form is then sent for approval to ICICI Lombard Health Insurance Company. Once the form is approved,the customer can avail the medical treatment.

Step 4: At the time of discharge fill in all the medical documents and pay for the services that are not covered under the policy.

Step 5: The hospital will send the hospital bills to ICICI Lombard Health Insurance Company . After review the company will pay the bill directly to the hospital.

ICICI Lombard has a simple, app-based claim process to make your experience hassle-free. You can contact the company for a claim, submit your documents, and check your claim status easily on their IL Take Care app.

What Are Reimbursement Claims?

Reimbursement Claims

In this type of claim, you can visit any hospital, not just those under your insurer’s cashless network. Here, you get your treatment done at the hospital, pay out of your pocket, and then apply for a reimbursement for the expenses with your insurer. At the time of making the claim, the customer needs to submit all hospital bills, prescriptions, and medical documents. These will need to be approved by ICICI Lombard Health Insurance Company before the claim is processed, meaning that it can take slightly more time to get through.

Here’s How You Can File Your Reimbursement Claims online

Step 1: You need to call ICICI Lombard Health Insurance within two days of your admission date. Post company’s call, they send you a link where you can upload the soft copies of all original documents (bills, reports, etc) and bank details of your desired bank account.

Step 2: Before uploading, you need to sign all the documents yourself.

Step 3: Upload the documents maximum within 30 days from the date of discharge or when you receive the link.

Step 4: You will receive the payment within 30 days from the receipt of the last necessary claim document.

ICICI Lombard Health Insurance provides a 15-day grace period for reimbursement claims. If the documents have not reached the company post this grace period due to an inadvertent delay, you can contact the company with the explanation for the same and resend/re-upload the documents.

Why Is Claim Settlement Ratio Important?

The claim settlement ratio is one of the most useful parameters that showcases the number of claims settled by the company in a financial year. It is an important factor that helps you to evaluate how soon the company will settle your claims in the time of need. Before buying health insurance, one should always check the history of claims settled by that company.

Prospective buyers might use the claim settlement ratio to determine how well the insurance company honors their claims. It is recommended to check the claim settlement ratio of all the plans having the lowest premiums and highest benefits.

A higher health insurance claim settlement ratio indicates the company's financial performance and its ability to pay off the claims made by its customers.

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 comprehensive health insurance plan that covers you & your family's healthcare needs with a wide range of SI (2 Lakhs to 50 Lakhs)

Unique Features

  • Available in 4 different variants
  • 100% Automatic Restoration of SI
  • Riders for enhanced coverage

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 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

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 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

Icici Lombard Claim Settlement Ratio: FAQs

1. What does a higher percentage of ICICI Lombard Claim Settlement Ratio mean?

The higher the claim settlement ratio, the higher could be the chances of your claim approval. Whereas, a poor claim settlement ratio could mean the insurance company follows stringent criteria for claim approval.

2. How can you calculate the percentage of ICICI Lombard Claim Settlement Ratio ?

The claim settlement ratio, also known as CSR, can be calculated by dividing the total number of claims settled by the insurance company by the total number of claims received by the insurance company.

Let's take an example: the total number of claims received by ICICI Lombard in a year is 1,000, out of which 980 are settled. In this case, the claim settlement ratio of ICICI Lombard for this particular year would be:

CSR=Total number of claims settled by ICICI Lombard / Total number of claims filed by the policyholders


3. Why should you consider a claim settlement ratio when buying a term plan?

The loss of the breadwinner of the family causes severe emotional and financial turmoil. However, ICICI Lombard Insurance Plan can reduce your worries and burden. While there are so many things to consider when buying a life insurance policy, the claim settlement ratio of the insurance company should be one of the key factors amongst them.

ICICI Lombard Health Insurance Reviews

For a better insight into the company, do not forget to go through the ICICI Lombard Health Insurance Reviews.

Customer Review Image

Anita Sandhu


March 18, 2024

A user-friendly platform with a lot of useful information with a helpful approach. The team of PolicyX went the extra mile to answer my questions related to ICICI Lombard Health Insurance Polic...

Customer Review Image

Khushpreet Singh


March 18, 2024

I bought my ICICI Lombard health insurance plan 4 years ago, and every year the team at PolicyX helps me to renew the plan. Thank you PolicyX for taking care like family.

Customer Review Image

Arjun Palta


February 28, 2024

I connected to the team member of PolicyX when I was looking for the best health insurance policy. They helped me buying ICICI Lombard health insurance plan for my family. They made it easier f...

Customer Review Image

Vayu Sharma


February 26, 2024

The insurance team at PolicyX was so helpful while purchasing my health insurance from ICICI Lombard Health Insurance.

Customer Review Image

Nipun Singh


February 26, 2024

I needed to apply for a claim settlement for my ICICI Lombard Health Insurance Policy. PolicyX helped me to get the reimbursement very soon.

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February 17, 2022

I have family insurance plan and my mother and sister hospitalised for covid together. hospital gave me big amount. I used insurance plan to pay the bills.

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Kalpana Pushkar


February 9, 2022

ICICI Lombard s individual health insurance plan is an excellent one that provided me with complete coverage at affordable rates.

Customer Review Image

Jubin Katyal


September 8, 2021

Very Good company ICICI. I am impressed with their services. I will recommend this compnay from my side

View All ICICI Lombard Health Insurance Reviews

Naval Goel

Reviewed By: Naval Goel

Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.