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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 14 1 2 3 4 5
  • ICICI Lombard Health Insurance
    "Good Policy"
    0.5 5.0/5 "Blown Away!"
    I have a health insurance policy with ICICI LOMBARD from last 2 months, there was no claim experience so far with this insurance policy. I am not aware of the premium amount as my company pays it. I have a coverage value of Rs 1 lac for this insurance.
    Was this review helpful? 0
    , bangalore
    Reviewed on Dec 13, 2018
  • ICICI Lombard Health Insurance
    "Good Policy"
    0.5 4.0/5 "Great!"
    My health insurance is with ICICI LOMBARD from last 9 years, i am not aware of the premium amount as my company pays it. I did not claim anything so far from this insurance policy. This policy has a coverage of Rs 5 lacs for medical and Rs 15 lacs for accidental.
    Was this review helpful? 0
    , chennai
    Reviewed on Dec 11, 2018
  • ICICI Lombard Health Insurance
    "Best policy"
    0.5 5.0/5 "Blown Away!"
    I hold a health insurance policy with ICICI Lombard from last 6 months, i am not aware of the premium amount as my company pays it. I have no claim experience so far with this insurance policy. I am happy with the coverage value of this insurance policy.
    Was this review helpful? 0
    , bangalore
    Reviewed on Dec 05, 2018
  • ICICI Lombard Health Insurance
    "Yet to experience the policy"
    0.5 4.0/5 "Great!"
    My organization has provided me a health insurance with ICICI Lombard. I do not have any claim experience as of now. I can able to utilize the coverage amount of Rs. 3 lakhs. Myself and my wife covered by this policy. They have provided the list of hospitals in the portal which is there in all over India and abroad also.
    Was this review helpful? 0
    , pune
    Reviewed on Nov 26, 2018
  • ICICI Lombard Health Insurance
    "Decent policy"
    0.5 5.0/5 "Blown Away!"
    I have been holding a helath insurance policy with ICICI Lombard 2.5 years back. I had a claim experience with them and its been good. Its a cashless treatment facility hence i have got the claim within one week. They have offered me a coverage amount of Rs. 45000. They have given me a health insurance for my family. I got a coverage value of Rs. 2 lakhs
    Was this review helpful? 0
    , hyderabad
    Reviewed on Nov 22, 2018
  • ICICI Lombard Health Insurance
    "Looking for more coverage"
    0.5 3.0/5 "Satisfactory"
    I have a health insurance policy with ICICI LOMBARD from last 1 year, i am not aware of the premium amount as my company pays it. There was no claim experience so far with this insurance policy and the coverage value is Rs 2 lacs.
    Was this review helpful? 0
    , chennai
    Reviewed on Nov 20, 2018
  • ICICI Lombard Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    My company has provided me a health insurance policy with ICICI Lombard. Its been 2years now. It covers for entire family and policy coverage is 3L per person. There is no claim experience but I heard the claim process was good. Am not aware of the benefits.
    Was this review helpful? 0
    , chennai
    Reviewed on Nov 17, 2018
  • ICICI Lombard Health Insurance
    "Need scope of improvement on claim process"
    0.5 4.0/5 "Great!"
    My I-protect family health plan is good, overall cover is for 15 lakhs for my entire family. They giving pre existing and cash less hospitalization cover. The service is also great but I heard they are not good in claim, they have some length process, they need some scope of improvement.
    Was this review helpful? 0
    , delhi
    Reviewed on Nov 01, 2018
  • ICICI Lombard Health Insurance
    "Good Policy"
    0.5 4.0/5 "Great!"
    I have a health insurance policy with ICICI LOMBARD from last 3.5 years, i am not aware of the premium amount of this insurance policy. The coverahge value for this insurance policy is 4 lacs. I have no claim experience so far with this insurance policy.
    Was this review helpful? 0
    , visakhapatnam
    Reviewed on Oct 30, 2018
  • ICICI Lombard Health Insurance
    "Best policy"
    0.5 5.0/5 "Blown Away!"
    I have a health insurance policy with ICICI Lombard from last 8 years, i am happy with the coverage value of this insurance policy. I pay a premium of Rs 16000 once in 2 years. My claim experience was good and they covered 90%, it was a cashless treatment.The coverage value is Rs 7 lacs for this insurance.
    Was this review helpful? 0
    , chennai
    Reviewed on Oct 09, 2018
  • ICICI Lombard Health Insurance
    "Good Policy"
    0.5 4.0/5 "Great!"
    I have a health insurance policy with ICICI LOMBARD from last 1.5 years, i am not aware of the coverage value of this insurance policy. I pay a premium of more than Rs 12000 for this insurance policy. I have no claim experience so far with this insurance policy.
    Was this review helpful? 1
    , vadodara
    Reviewed on Oct 08, 2018
  • ICICI Lombard Health Insurance
    "Harrassment by ICICI Lombard"
    0.5 0.5/5 "Unacceptable"
    My policy that I had bought for my mother was Rejected on the grounds that she had suffered a ministroke that I hadnt disclosed. These claims by ICICI Lombard were absolutely false. My mother never suffered a stroke and I had to spend 15-20 days to constant emailing and calling the customer care and finally reaching the leadership of ICICI Lombard to get the claims approved. This was the first claim I had after paying premium for 7 years and this is the way they treated me. Cheap tactics. Incident occured in Sep-2017
    Was this review helpful? 3
    , mumbai
    Reviewed on Oct 04, 2018
  • ICICI Lombard Health Insurance
    "Best policy"
    0.5 5.0/5 "Blown Away!"
    I have a health insurance policy with ICICI lombard, a premium of Rs 814 has to be paid every month for this insurance policy. I have no claim experience so far with this insurance policy. They cover Rs 10 lacs for accident and Rs 1.5 lacs for other coverage.
    Was this review helpful? 0
    , vadodara
    Reviewed on Sep 25, 2018
  • ICICI Lombard Health Insurance
    "Normal Service"
    0.5 4.0/5 "Great!"
    I've a health insurance policy with the ICICI Lombard. I am paying low premium, there hasn't been any claim experience with the policy so far. Considering the premium I pay it has been a normal experience with the policy so far.
    Was this review helpful? 1
    , udaipur
    Reviewed on Sep 11, 2018
  • ICICI Lombard Health Insurance
    "Good Service"
    0.5 5.0/5 "Blown Away!"
    I've a health insurance policy with the ICICI Lombard, I am paying the premium and I do not have any claim experience with the policy so far. I'll have to wait and see how they respond to my claim requests in future. It has been a hassle free experience so far.
    Was this review helpful? 0
    , bangalore
    Reviewed on Sep 11, 2018
  • ICICI Lombard Health Insurance
    "Normal Service"
    0.5 4.0/5 "Great!"
    I've a health insurance policy with the ICICI Lombard. I am paying a premium 280 per month, for me and family. I do not have any claim experience with the policy. The annual coverage 2.5 Lacs. It has been a hassle free experience with the policy so far.
    Was this review helpful? 0
    , bangalore
    Reviewed on Sep 05, 2018
  • ICICI Lombard Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    This insurance policy had been taken through the company which i am working and it is a good beneficial policy where they also have cashless treatment. There are many hospitals which are covered in my locality as well. There has not been any claims made so far and there has not been any hassles so far.
    Was this review helpful? 0
    , visakhapatnam
    Reviewed on Sep 03, 2018
  • ICICI Lombard Health Insurance
    "Good Policy"
    0.5 4.0/5 "Great!"
    My health is insured with ICICI Lombard from last 121 years and it is one of the good policy to use. I pay a premium of Rs 5800 for this insurance policy and it covers only individual. My claim experience was good, they covered 90% and it was cashless treatment. The coverage valye is up to Rs 4-5 lacs.
    Was this review helpful? 1
    , mumbai
    Reviewed on Aug 21, 2018
  • ICICI Lombard Health Insurance
    "Good Policy"
    0.5 4.0/5 "Great!"
    I have my health insured with ICICI Lombard from last 3 years, i am not aware of the premium amount as my company pays it . The coverage value for this insurance policy is for Rs 2 lakhs and it is a family coverage. I have no claim experience so far with this insurance policy.
    Was this review helpful? 1
    , hyderabad
    Reviewed on Aug 21, 2018
  • ICICI Lombard Health Insurance
    "Good Policy"
    0.5 4.0/5 "Great!"
    I have my health insured with ICICI Lombard from last 2 months, i am happy with the coverage value of this insurance policy and they cover up to Rs 4 lakhs. I have no claim experience so far with this insurance policy and i pay a premium of Rs 10000 for this insurance policy.
    Was this review helpful? 1
    , hyderabad
    Reviewed on Aug 17, 2018
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