ICICI Lombard Health Insurance: Plans, Claim Settlement Ratio, Network Hospital List & Renewal

ICICI Lombard Claim Settlement Ratio

99.7%

ICICI Lombard

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. ICICI Lombard has a claim settlement ratio of 99.7%, as compared to the industry average of 94.21%.

Know More About ICICI Lombard Claim Settlement

ICICI Lombard Health Insurance Plans Overview

ICICI Lombard health insurance offers 2 health insurance plans. The sum insured ranges from Rs. 3 Lakh - 3 Cr. Details of the comprehensive coverage provided by the following 2 ICICI Lombard health insurance plans are listed below:

ICICI Lombard Health AdvantEdge Policy

Starting Premium- NA

With ICICI Lombard General Insurance Company Limited, choosing an insurance policy is not just a matter of saving tax at the end of the financial year. It is also about finding a policy that actually works for you. Once selected, a single policy will provide a health cover that fits you and your family like a glove.The plan also covers Air Ambulance charges, ASI (NCB) is protected if claim is less then Rs 50000/year, Claim service Guarantee and unlimited free Tele-consultation and much more.

Restore Benefit - 100% of the base SI shall be made available even in case of partial utilization of SI for hospitalization due to any illness for same person.
Wellness Program: Earn wellness points through activities promoting health behavior like gymming, yoga, etc. You can redeem your earned wellness points against reimbursement of medical expenses like consultation charges, medicine and drugs, diagnostic expenses, dental expenses, wellness and preventive care and other miscellaneous charges that are not covered under any medical insurance.
Tele consultation: ICICI will arrange consultations and recommendations for routine health issues by a qualified Medical Practitioner or health care professional.
E-opinion (Second opinion).
Diet & Nutrition e-consultation.

Eligible Age

91 days - 65 years

Coverage

5 Lakh - 3 Cr

ICICI Lombard Health Shield Policy

Starting Premium- NA

With ICICI Lombard General Insurance Company Limited, choosing an insurance policy is not just a matter of saving tax at the end of the financial year. It is also about finding a policy that actually works for you. Once selected, a single policy will provide a health cover that fits you and your family like a glove.The plan also covers Air Ambulance charges, ASI (NCB) is protected if claim is less then Rs 50000/year, Claim service Guarantee and unlimited free Tele-consultation and much more.

Unlimited reset benefit: Reset upto 100% of the entire sum insured. Reset won't trigger on first claim and for same illness claimed by same person again.
Wellness Program: Earn wellness points through activities promoting health behavior like gymming, yoga, etc. You can redeem your earned wellness points against reimbursement of medical expenses like consultation charges, medicine and drugs, diagnostic expenses, dental expenses, wellness and preventive care and other miscellaneous charges that are not covered under any medical insurance.
Tele consultation: ICICI will arrange consultations and recommendations for routine health issues by a qualified Medical Practitioner or health care professional.
E-opinion (Second opinion).
Diet & Nutrition e-consultation.

Eligible Age

91 days onwards

Coverage

3 Lakh - 50 Lakh

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Top Features From ICICI Lombard Health Plans

Complete Coverage for Hospitalisation: ICICI Lombard Health Insurance Plans offer comprehensive coverage to the insured,including for pre- and post-hospitalisation expenses.
Cashless Hospitalisation: Policyholders can avail of cashless hospitalisation benefits under ICICI Lombard Health Insurance.In case of any medical emergency and the need for urgent hospitalisation,you can opt for treatment at one of our several network hospitals, completely cashless.
Top-Up Plans: A top-up plan offers extra coverage for any additional payment that you may need to incur over and above your existing health insurance plan by ICICI Lombard.
Critical Illnesses: ICICI Lombard provides health insurance coverage for all critical and life-threatening diseases that generally require longer and costlier treatment.
Pre-existing Diseases: Coverage for pre-existing diseases is also provided; however, it is subject to the survival and waiting period under ICICI Lombard Health Insurance policy.

Exclusions Across ICICI Lombard Health Plans

Pre-existing Health Conditions: Pre-existing diseases such as asthma, cardiac conditions, diabetes, and hypertension will not be covered before 24-48 months of continuous coverage.
Intentional Self-Injury: Suicide attempts or injuries owing to illegal acts are not covered.
Lifestyle Conditions: Illnesses owing to poor lifestyle habits such as tobacco chewing, smoking, alcohol, drugs, and more will be excluded from coverage under ICICI Lombard Health Insurance.
Maternity Complications: Any problems or complexities arising during pregnancy, abortion, childbirth, or miscarriage are excluded from health insurance.
War or Nuclear Injuries: Harm caused by war injuries or those suffered during nuclear attacks, exposure to harmful radiations, biological, or chemical warfare are not covered.
Dental/Eye Treatments: These are generally not covered under health insurance coverage by ICICI Lombard.
HIV/AIDS: Treatment for these conditions is excluded from the health plans.
Alternative Treatments: Therapies such as Naturopathy, Ayurveda, and Homeopathy are not covered.
Cosmetic Surgery: Specific cosmetic treatments for the improvement or enhancement of a body part do not fall under medical insurance coverage of ICICI Lombard Health Insurance.

ICICI Lombard Premium Calculator

Use the ICICI Lombard health insurance premium calculator to estimate your health insurance premiums.

Premium Calculator

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ICICI Lombard Cashless Network Hospitals

ICICI Lombard has a network of 1013 cashless hospitals across India. To find the nearest ICICI Lombard health insurance network hospital, enter your location.

Delhi

Mumbai

Ahmedabad

Check All ICICI Lombard Network Hospitals

ICICI Lombard Customer Care

Customer Care Number

1800 2666

Email ID

customersupport@icicilombard.com

ICICI Lombard Claim Process

ICICI Lombard supports both cashless claims and reimbursement claims. This section covers the information on how to check ICICI Lombard health insurance claim status, fill ICICI Lombard health insurance claim form, and the claim settlement process.

Step 1: Choose a Network Hospital
In times of medical emergencies, go to the nearest network hospital of ICICI Lombard Health Insurance. You may need to get admitted for treatment at the hospital.

Step 2: Contact the Hospital Insurance Desk
Once admitted, a family member or any other contact of the insured must get in touch with the insurance desk at the network hospital. It would provide complete details on the claim-settlement procedure followed at the hospital.

Step 3: Contact the TPA
Third-Party Administrator or TPA is present at the insurance desk of every hospital. Request for a claim form from the TPA to duly fill in for filing a claim request.

Step 4: Submit the Form
After filling out all the required details on the form, submit it to the TPA desk along with the pre-authorisation letter or TPA declaration.

Step 5: Receipt of Email
You will receive an email confirming insurance coverage and the maximum amount sanctioned under the ICICI Lombard Health Insurance Plan.

Step 6: Settlement of Bill
Upon completion of your treatment, you can be dischargd from the hospital without having to pay any money to the hospital desk. If the final bill is within the limit of your sanctioned amount by ICICI Lombard Health Insurance, it will be settled directly with the hospital by the insurer.

Step 1: Inform the Insurer
You must inform ICICI Lombard Health Insurance regarding your hospitalisation before making a reimbursement claim.

Step 2: Make Sure your Documents are in Order
After completing your treatment at the hospital, you would be required to pay the final bill at the time of discharge, unlike cashless hospitalisation. Once you have made the payment, you can file for a reimbursement claim with the insurer. Make sure that all your documents for hospitalisation are in order before making the claim. These include original prescription by the doctor, pharmacy and other medical expenses, diagnostic test expenses, hospital bills, and medical reports.

Step 3: Fill Out and Submit the Claim Form
Download the claim form from the official website of ICICI Lombard Health Insurance. Fill out the required details on the form and get it certified by your treating doctor at the hospital. Mail the form along with the complete set of documents to the insurer.

Step 4: Claim Request Processing
After submission of all the documents, ICICI Lombard Health Insurance will go through your claim request and may approve or reject it based on your policy coverage. In case approved, your claim amount will be transferred to your bank account.

ICICI Lombard Health Insurance Renewal Process

ICICI Lombard Health Insurance plans offer lifetime renewability. This means that you can easily renew your policy year after year upon lapse and continue enjoying its coverage benefits for a lifetime.

You can conveniently apply for ICICI Lombard Health Insurance renewal online on the company’s website. Alternatively, you may call the customer care number to initiate the process or connect with one of the team representatives at a branch near you for more assistance. Listed below is the simple step-by-step procedure to renew your ICICI Lombard Health Insurance policy online:
Step 1: Enter the required details on the ICICI Lombard Health Insurance website - https://www.icicilombard.com/. These would include the age group, number of insured people in the policy, and contact details.
Step 2: Now, choose the amount of coverage for your health insurance. Note that you are entitled to a 10% discount on a health cover chosen for 2 years.
Step 3: New users may need to register to sign up, while existing users can use their login credentials to sign in to their account on the website.
Step 4: You will be asked to enter the details of the insured, such as the name of the applicant, your relationship with the insured, and date of birth. Also, enter the contact details of the insured as well as the details of the nominee.
Step 5: Before making the payment, review the complete details entered and make any changes at this stage, if required.
Step 6: Now, choose your preferred payment option and enter your payment details to complete the payment.
Step 7: Once paid successfully, your ICICI Lombard health policy renewal process is complete. You may download and save a copy for your reference.

In case you are unable to follow the online renewal process, you may do the procedure offline by visiting the nearest branch of ICICI Lombard Health Insurance. Additionally, a Turtlemint expert insurance advisor would love to help you through the process. Visit www.turtlemint.com or download our app here.

Reference Links
https://www.icicilombard.com/about-us/who-we-are
https://www.probusinsurance.com/health-insurance/icici-lombard-health-insurance/
https://www.insurancedekho.com/health-insurance/icici-lombard/top-up
https://www.icicilombard.com/insurancevideos/Complete-Health-Insurance.html