• ICICI Lombard Health Insurance Claims Procedure

    Founded in the year 2001, ICICI Lombard was the result of a partnership between the India-based ICICI Bank Limited with the Canada-based Fairfax Financial Holdings Limited, a financial services organization. ICICI Lombard is one of India’s most prominent insurance player in the private segment which offers its services and products via its 221 branches that are located across India. In the health insurance segment, ICICI offers a number of health insurance policies, each of which is designed to fulfill all your healthcare needs. Along with their health insurance policies, ICICI also boasts of a robust claim filing and settlement process which is hassle-free and simple.

    Types of Health Insurance Claims:

    Health insurance claims can be filed as one of two types - cashless claims or reimbursement claims. A Cashless/Cashless Hospitalization/Cashless Treatment Claim will arise when the insured wishes to seek medical treatment at an ICICI Lombard network hospital. Under cashless treatment, the insured will not be required to pay the treatment/hospitalization bill, which will be footed by the insurance company upon successful verification of the claim. Cashless hospitalization can be availed for planned or emergency hospitalization. The other type of claim that can be made on a health insurance policy is a Reimbursement Claim. Under this claim, the insured must bear the costs of hospitalization/medical treatment, and later ask the insurance company to reimburse these costs.

    For 2015-16:

    Net Earned Premium (in lakhs INR) Net Claims Paid (in lakhs INR) Incurred Claims Ratio (Percentage)
    107460 88212 82.09

    Process for Cashless Claims:

    Cashless claims can be filed for planned and emergency hospitalization. In case of planned hospitalization, the insurance company must be informed at least 48 hours in advance while for emergency hospitalization, the insurer must be informed not later than 24 hours after hospitalization has taken place. Following are the steps to be followed to make a cashless claim.

    • You would first need to get in touch with the network hospital that provides cashless facility for ICICI Lombard health insurance. You need to ensure that you have your health card with you which would be issued by ICICI Lombard and seek admission for your treatment..
    • You need to intimate the cashless facility. Simply call the number mentioned on the card or the health insurance helpline number mentioned on the company website. For planned hospitalization make sure you reach out to the company 2 days prior to admission.
    • Submit the health card along with a proof of ID to the network hospital who in turn will conduct the verification of your credentials.
    • A pre-authorization form will be required to be filled in, from the hospital, where the attending doctor will have to sign it. This can be downloaded from the ICICI Lombard website but needs to be faxed to the insurance company along with relevant information.
    • The health insurance company will then communicate with the relevant bank to update the status of the claim made, which could be either be acceptance or rejection or possibly the request for additional information or documentation. You can check out the claim status on the website itself.
    • Once accepted, the medical bills and costs covered under the policy are settled by ICICI Lombard. But the things or expenses not covered under the health insurance have to be paid by you.
    • As a policy owner you need to verify and sign the original bills and at the same time keep a photocopy of the entire hospitalization record.

    Process for Reimbursement Claims:

    For filing a Reimbursement claim, here are the steps to be followed.

    • Inform ICICI Lombard when you are hospitalized.
    • Once your hospitalization/treatment is complete and you have paid the bills for the same, you must retain all bills and documents related to the treatment/hospitalization with you to file for the claim.
    • Submit the aforementioned bills and documents to ICICI Lombard for processing of the claim. If the treatment is covered under the scope of the terms of your policy and you have provided all the necessary documents, the insurer will process your claim and reimburse you for the amount of the bills, in accordance with the coverage of the policy.

    Documents Required for Claim Processing:

    • Claim Form: The claim form which needs to be filled with relevant details, signatures and finally be submitted.
    • Hospital Bills and Summary: All the original hospital bills, with stamps and signatures from the hospital have to be submitted.
    • The original discharge report has to be submitted as well.
    • All other originals reports related to the treatment (including medicine bills and investigation reports) has to be submitted.
    • The future line of treatment as well as follow-up check-ups by the relevant doctor should be sent as well.
    • If seeking treatment in a non-network or unregistered hospital, you need to get the details of the hospital on the official letterhead that includes the number of doctors, nurses and beds available.

    This Insurance Company has not partnered with BankBazaar.com. For more details, please visit its website/branch office. The trademarks, logos and other subject matters of intellectual property belong to their respective owners.

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

    ICICI Lombard Health Insurance Claims Procedure Reviews

  • Page 1 of 12 1 2 3 4 5
    • ICICI Lombard Health Insurance
      "Good policy to use"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with ICICI lombard from last 2 years and it is a good insurance policy to use. My premium of this policy gets auto deducted from the salary account. My claim experience was not up to the mark. I have a coverage of Rs 1.5 lakhs for accident and Rs 1 lakh for health. I am happy with the coverage and benefits of this policy.
      Was this review helpful? 0
      , ghaziabad
      Reviewed on Feb 23, 2018
    • ICICI Lombard Health Insurance
      "Overall, its good"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the ICICI Lombard general insurance company and the medical coverage value is good like it provides shadow for my needs. Claim benefits are good one with the ICICI lombard general insurance company.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Feb 07, 2018
    • ICICI Lombard Health Insurance
      "GOOD SERVICE"
      0.5 4.0/5 "Great!"
      I have a corporate health insurance with Icici for the benefits for my whole family and the offers and benefits are good with Icici. The payments where through online but I never got any claim experience with Icici corporate health insurance service.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jan 25, 2018
    • ICICI Lombard Health Insurance
      "Good service"
      0.5 4.0/5 "Great!"
      I have a good experience with ICICI General Insurance,i have taken a health insurance .I need not pay a premium amount instead company does it for the employees,i get a policy coverage of three lakhs.I have no claim experience with them so far.
      Was this review helpful? 0
      , chennai
      Reviewed on Jan 24, 2018
    • ICICI Lombard Health Insurance
      "Average service"
      0.5 3.0/5 "Satisfactory"
      I have a health insurance service from ICICI Lombard services ,the services are very good. The payments were payed through organization where I am working. The offers they provide is good with claim procedure is fast about 1 lakh.It was an average experience which I had with Icici health insurance service.
      Was this review helpful? 0
      , vijayawada
      Reviewed on Jan 22, 2018
    • ICICI Lombard Health Insurance
      "Wonderful"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy ICICI Lombard general insurance company. I would like to say that the service aspects are good one and the coverage value is around 16 lakh Rupees for my whole family. I do not have any claim experience to talk about.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jan 12, 2018
    • ICICI Lombard Health Insurance
      "Good service"
      0.5 5.0/5 "Blown Away!"
      I have taken Health Insurance with ICICI Lombard.I have claim experience with them they have reimbursed 80% from the value.I have been holding the policy for 10-15 years.The policy coverage is 2-5 lakhs.They give an immediate response to the customer.
      Was this review helpful? 0
      , chennai
      Reviewed on Jan 09, 2018
    • ICICI Lombard Health Insurance
      "Good & Convenient"
      0.5 4.5/5 "Excellent!"
      When I joined the company they offered me health insurance. The services are good with ICICI Lombard. I haven't used this cashless treatment but the coverage is good. I have no claim experience with them If I had any requirement need to raise a request then they will contact me.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Dec 30, 2017
    • ICICI Lombard Health Insurance
      "Best service"
      0.5 4.0/5 "Great!"
      I have taken a Health Insurance with ICICI Lombard.The premium is debited from my salaried account.I have taken an insurance recently i have no claim experience with them.I pay a premium of 1200 every month.Th website is easy to understand and navigate.
      Was this review helpful? 0
      , jaipur
      Reviewed on Dec 27, 2017
    • ICICI Lombard Health Insurance
      "Good Coverage"
      0.5 5.0/5 "Blown Away!"
      I took a Health Insurance with ICICI for quite a while now. The coverage they provide is very good. For my whole family I am getting a coverage of Rs.10 Lakhs over here. The network hospital here is very good and the claim experience also with them is quite good.
      Was this review helpful? 0
      , ahmedabad
      Reviewed on Dec 19, 2017
    • ICICI Lombard Health Insurance
      "Good insurance policy"
      0.5 3.0/5 "Satisfactory"
      I have a health insurance policy with ICICI Lombard from last 1 year and it is a good insurance policy to use. This policy has to be renewed every year and i pay a premium of Rs 5000 on annual basis. I do not have claim experience and i have not taken cashless treatment. The coverage is very good in this policy
      Was this review helpful? 0
      , mumbai
      Reviewed on Dec 15, 2017
    • ICICI Lombard Health Insurance
      "Better policy to use"
      0.5 4.0/5 "Great!"
      The ICICI LOMBARD GENERAL INSURANCE Health policy covers 2 members in my family which is myself and my father. I pay the premium of around Rs,9000 every year, The customer support is good with the ICICI Lombard, I can get the claim amount up to 1lakh rupees.
      Was this review helpful? 1
      , hyderabad
      Reviewed on Dec 13, 2017
    • ICICI Lombard Health Insurance
      "Good policy"
      0.5 5.0/5 "Blown Away!"
      I have taken a Health Insurance with ICICI Lombard.I am holding the policy for eight years.I make payments of 20,000 per annum debited from the salaried account.They policy coverage is 10 lakhs including the dependants.I don't have claim experience so far.
      Was this review helpful? 0
      , kochi
      Reviewed on Dec 13, 2017
    • ICICI Lombard Health Insurance
      "Excellent policy"
      0.5 5.0/5 "Blown Away!"
      I hold the Health insurance Policy for past 14years. This policy covers my whole family including my parents. I have the claim amount of Rs,4lakshs for the hospitalization, for the life coverage I have the claim amount of Rs,40lakhs. I am satisfied having the health insurance policy, which is given by my company.
      Was this review helpful? 0
      , chennai
      Reviewed on Dec 11, 2017
    • ICICI Lombard Health Insurance
      "Good"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the ICICI Lombard general insurance company and I have not faced any claims with them. Everything is good one with the ICICI lombard general insurance company.
      Was this review helpful? 1
      , hyderabad
      Reviewed on Dec 06, 2017
    • ICICI Lombard Health Insurance
      "Good health insurance policy"
      0.5 4.0/5 "Great!"
      I am having ICICI Lombard health insurance policy from last 2 years and it is a very good policy to use. This policy has to be renewed every year. I pay my premium on annual basis through online. I do not have claim experience and i have not taken cashless treatment. I am satisfied with the coverage and benefits of this policy.
      Was this review helpful? 0
      , kolkata
      Reviewed on Dec 05, 2017
    • ICICI Lombard Health Insurance
      "Good Policy to hold"
      0.5 4.0/5 "Great!"
      I have a health insurance with ICICI LOMBARD GENERAL INSURANCE. I have been having this health insurance for the past few years. My company pays for my health insurance. It covers me and my family. Till now I didn't have any claim experience with them.
      Was this review helpful? 0
      , bangalore
      Reviewed on Nov 20, 2017
    • ICICI Lombard Health Insurance
      "Good Health Insurance"
      0.5 5.0/5 "Blown Away!"
      I was given a coverage of Rs. 7 Lakhs, with a premuim of Rs.18000 for two year. I am entitiled to Rs. 2 Lakhs for no claim benefit also. They have good number of Hospital in their list and cashless is also available. I felt the Insurance to be perfect.
      Was this review helpful? 0
      , pune
      Reviewed on Oct 29, 2017
    • ICICI Lombard Health Insurance
      "Better Policy"
      0.5 4.0/5 "Great!"
      Through my company I got the Health insurance policy with ICICI Lombard company. I got this policy around 2years ago. I never had any medical claim experience with this policy. The medical coverage is good, because it covers Rs.4lakhs. This policy covers 4members which is myself, my spouse and my children.
      Was this review helpful? 0
      , vadodara
      Reviewed on Sep 29, 2017
    • ICICI Lombard Health Insurance
      "Pretty good"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the ICICI Lombard general insurance company. I would like to say that the coverage value is good one with the ICICI Lombard general insurance company and claim dint get happens in the time as of now.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Sep 17, 2017
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