What is ICICI Lombard Health Insurance Claim Settlement?

ICICI Lombard Health Insurance Claim Settlement refers to the insurer paying for your medical expenses through cashless treatment or reimbursement after hospitalization.

How does ICICI Lombard calculate its claim settlement ratio?

The ratio is calculated as:Claims Settled ÷ Claims Received × 100, showing the percentage of claims paid by the insurer.

What types of claims are available under ICICI Lombard Health Insurance?

You can file claims in two ways—cashless claims at network hospitals and reimbursement claims at non-network hospitals.

How does the cashless claim settlement process work?

Visit a network hospital, present your health card, complete the pre-authorization form, and the insurer directly settles approved medical bills with the hospital.

What is the process for reimbursement claim settlement?

Pay the hospital bill, collect all original documents, fill the claim form, and submit them to ICICI Lombard for reimbursement under the ICICI Lombard Health Insurance Claim Settlement Process.

How long does ICICI Lombard take to settle claims?

Cashless claims are approved within 30 minutes to 2 hours, while reimbursement claims are processed in 7–10 working days after document submission.

Is ICICI Lombard’s claim settlement process fully digital?

Yes, ICICI Lombard Health Insurance Claim Settlement can be initiated and tracked through a fully digital and paperless process via the website or app.

What documents are required during the claim settlement process?

You need the discharge summary, hospital bills, prescriptions, diagnostic reports, ID proof, and a filled claim form for smooth ICICI Lombard Health Insurance Claim Settlement.

Can I check my claim status online?

Yes, you can track the status of your ICICI Lombard Health Insurance Claim Settlement online through the insurer's claim status portal.

Why do ICICI Lombard health claims get rejected?

Claims can be rejected due to incomplete documents, non-disclosure of pre-existing disease, policy mismatch, or expenses not covered under your plan.

How can I avoid claim rejection?

Share accurate information, submit correct documents, disclose pre-existing diseases, and follow all steps in the ICICI Lombard Health Insurance Claim Settlement Process.

Can I get cashless treatment at any hospital?

Cashless treatment is available only at ICICI Lombard’s 10,000+ network hospitals across India.

What should I do during emergency hospitalization?

Inform ICICI Lombard within 24–48 hours, provide your health card at the hospital, and initiate the cashless claim settlement process immediately.

Do pre- and post-hospitalization expenses come under claim settlement?

Yes, ICICI Lombard covers these expenses as part of the Health Insurance Claim Settlement, depending on the number of days allowed in your plan.

Are day-care procedures covered in the claim settlement?

Yes, day-care treatments that don’t require 24-hour hospitalization are eligible under the ICICI Lombard Health Insurance Claim Settlement Process.

Can I file multiple claims in one year?

Yes, you can file multiple claims as long as they stay within your total sum insured limit.

What happens if the hospital is not part of ICICI Lombard’s network?

You can still get treated and file a reimbursement claim, which will be processed under the ICICI Lombard Health Insurance Claim Settlement guidelines.

Why choose ICICI Lombard for claim settlement?

With a strong claim settlement ratio, fast approvals, digital processes, and a large hospital network, ICICI Lombard ensures a smooth and dependable Health Insurance Claim Settlement experience.

What is the claim settlement ratio of ICICI Lombard Health Insurance?

ICICI Lombard has an average Health Insurance Claim Settlement Ratio of around 92%, reflecting strong claim-handling reliability and timely approvals.

OneAssure

Health Insurance

ICICI Lombard Health Insurance

Claim Settlement Ratio

ICICI Lombard Health Insurance Claim Settlement

Q: What is the ICICI Lombard Health Insurance Claim Settlement Process?

The ICICI Lombard Health Insurance Claim Settlement Process involves notifying the insurer, submitting documents, getting pre-authorization for cashless treatment, and receiving payment approval or reimbursement.

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About Claim Settlement

Customer Testimonials

Real experiences from our valued customers who have chosen our insurance coverage.

Have been associated with Ruchir and his team… They have provided me excellent guidance in choosing the right plans for myself and my family…

…always been available to assist with any insurance/claim queries.

Nakul N

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

Have been associated with Ruchir and his team… They have provided me excellent guidance in choosing the right plans for myself and my family…

…always been available to assist with any insurance/claim queries.

Nakul N

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

My heartfelt thanks to the OneAssure team for making my insurance claim process effortless. Right from the very first interaction, they demonstrated professionalism, clear communication, and an impressive command of the procedures involved. Their swift updates, timely guidance, and persistent follow-through removed all the stress from what could have been a complicated experience.

Anju Renjith

I am truly grateful for the support and guidance I received in settling my insurance claim. The entire process was handled with great professionalism, clarity, and efficiency. Their prompt response, deep knowledge of the procedures, and consistent follow-ups ensured a smooth and hassle-free experience.

Thank you once again for your invaluable help, highly recommended!

Yogesh Meena

I recently had the pleasure of purchasing health insurance for my parents through this company, and my experience has been exceptional...The team was incredibly patient and took the time to explain every detail to me. No matter how many times I asked questions, they were always calm and thorough in their explanations. Their professionalism and dedication made a significant difference in helping me make an informed decision.

Akash Kumar

OneAssure helped me understand my needs and choose a product that was right for me. There was no pressure tactics or mis-selling. This experience was respectful, informed, and completely stress-free.

Shreya Goyal

Had a great experience with OneAssure during my insurance claim process. A special shoutout to Sunad Raj for his exceptional support, he was professional, responsive, and guided me every step of the way. Thanks to his consistent follow-ups and clear guidance, the entire claim settlement was smooth and hassle-free. Highly recommend OneAssure for their service and transparency!

Sanjay Dakalia

The team is very professional and prompt. I would have all my health and life insurance needs met through them.

Harish Jindal

Very professional service from Ruchir & Aman. They were recommended by a friend who had a positive experience with them. I have taken both health and life policies through them and they have advised me well throughout the process and found the best options available in the market. I had a medical condition due to which it was difficult to find a suitable health policy in the market, however this team was able to find one for me. I would recommend their services to anyone looking to buy health or life insurance.

Siddhartha Saha

Wonderful experience with Prost. Right from suggesting the insurance products to claim process the entire experience hai been seamless. They do not mis-sell and are very transparent. Sundar Raj from the team has been wonderful and ensured prompt guidance.

All the best Ruchir and keep up the good work!

Adarsh Ravindranathan

Our Verdict

Our Verdict on ICICI Lombard Health Insurance Claim Settlement Ratio & Process

Pros

Fast digital claim processing with helpful customer support.

Over 15 lakh claims settled, showcasing solid experience.

Wide 10,600+ cashless hospital network for easy access.

High 97.16% Claim Settlement Ratio, ensuring strong reliability.

Cons

Cashless approval time may vary by hospital.

Reimbursement claims require detailed documentation.

Sub-limits or co-pays in some plans may reduce payout.

Long waiting periods for pre-existing diseases.

Pros

Fast digital claim processing with helpful customer support.

Over 15 lakh claims settled, showcasing solid experience.

Wide 10,600+ cashless hospital network for easy access.

High 97.16% Claim Settlement Ratio, ensuring strong reliability.

Cons

Cashless approval time may vary by hospital.

Reimbursement claims require detailed documentation.

Sub-limits or co-pays in some plans may reduce payout.

Long waiting periods for pre-existing diseases.

Final Verdict

ICICI Lombard offers one of the most dependable claim experiences in the industry, backed by its 97.16% claim settlement ratio, 10,600+ hospital network, and 15 lakh+ settled claims. Its digital-first claim system, quick approvals, and well-defined procedures provide policyholders with confidence and convenience during medical emergencies. While waiting periods, sub-limits,...

ICICI Lombard offers one of the most dependable claim experiences in the industry, backed by its 97.16% claim settlement ratio, 10,600+ hospital network, and 15 lakh+ settled claims. Its digital-first claim system, quick approvals, and...

What is ICICI Lombard’s Claim Settlement & Process?

Cashless Claims

Get treated at any network hospital without paying upfront. ICICI Lombard directly settles approved bills with the hospital.

Reimbursement Claims

If treated at a non-network hospital or if you pay first, submit your bills and documents to ICICI Lombard to get reimbursed after verification.

Cashless Claims

Get treated at any network hospital without paying upfront. ICICI Lombard directly settles approved bills with the hospital.

Reimbursement Claims

If treated at a non-network hospital or if you pay first, submit your bills and documents to ICICI Lombard to get reimbursed after verification.

Claim Settlement Process

How to file ICICI Lombard Health Insurance claims?

Documents Required for ICICI Lombard Health Insurance Claims

Health Card / e-Card

Proof of active policy at the hospital.

Government ID Proof

Aadhaar, PAN, Passport, Voter ID, or Driving License.

Policy Schedule / Policy Number

Confirms plan details and eligibility.

Doctor’s Admission Note / Consultation Papers

Explains the need for hospitalization.

Hospital Estimate Letter

Provides expected treatment costs.

Pre-Authorization Form

Mandatory for cashless claim approval.

Discharge Summary & Final Bills

Detailed record of treatment and expenses.

Health Card / e-Card

Proof of active policy at the hospital.

Government ID Proof

Aadhaar, PAN, Passport, Voter ID, or Driving License.

Policy Schedule / Policy Number

Confirms plan details and eligibility.

Doctor’s Admission Note / Consultation Papers

Explains the need for hospitalization.

Hospital Estimate Letter

Provides expected treatment costs.

Pre-Authorization Form

Mandatory for cashless claim approval.

Discharge Summary & Final Bills

Detailed record of treatment and expenses.

How to Check Status

How to Check ICICI Lombard Health Insurance Claim Status

You can easily track your ICICI Lombard health insurance claim by visiting the insurer’s official website. The online portal allows you to monitor your claim’s progress, approvals, and updates in real time.

ICICI Lombard Health Insurance Claim Statistics

~98.5%

10600+

~3 days Average Health Claim Settlement Time

~98.5%

10600+

~3 days Average Health Claim Settlement Time

How Claim Settlement Ratio (CSR) Is Calculated

Understanding CSR

CSR indicates the percentage of claims an insurer successfully settles. A higher CSR reflects reliability and efficiency.

The Formula

CSR = (Number of Claims Settled ÷ Number of Claims Received) × 100

Example

If an insurer receives 10,000 claims and settles 9,900:

CSR = 9,900 ÷ 10,000 × 100 = 99%

What It Means for You

A 99% CSR shows the insurer settles 99 out of every 100 claims, indicating strong credibility and smooth claim handling.

Understanding CSR

CSR indicates the percentage of claims an insurer successfully settles. A higher CSR reflects reliability and efficiency.

The Formula

CSR = (Number of Claims Settled ÷ Number of Claims Received) × 100

Example

If an insurer receives 10,000 claims and settles 9,900:

CSR = 9,900 ÷ 10,000 × 100 = 99%

What It Means for You

A 99% CSR shows the insurer settles 99 out of every 100 claims, indicating strong credibility and smooth claim handling.

Why ICICI Lombard Health Insurance Claims Get Rejected

Incomplete or Incorrect Documents

Claims may be denied if essential documents, Aadhaar, PAN, Passport, Voter ID, or Driving License, are missing or contain mismatched details.

Identity or Policy Mismatch

If personal details in the documents do not match the policy records, claims can be delayed or rejected.

Missing Age or Relationship Proof

Failure to submit supporting documents like Birth Certificates, School Records, Aadhaar, Passport, or PAN for validating age or family relation can lead to rejection.

Unverified Financial or Employment Details

Certain cases require Salary Slips, Bank Statements, ITR, or Form 16. Missing or unverifiable financial information may also result in claim rejection.