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About ICICI Lombard Health Insurance

One of India's top private general insurance companies, ICICI Lombard, offers a wide array of insurance products.ICICI Lombard Health Insurance is one of its leading products that is in high demand among customers. Some of the other insurance products offered by the insurer include motor insurance, crop insurance, personal accident insurance, engineering insurance, fire insurance, liability insurance, and marine insurance.

The inclusion of benefits such as extensive coverage for hospitalization expenses, pre and post-hospitalization expenses, day-care procedures, and more contributes positively to an ICICI Lombard health insurance review.

ICICI Lombard has been in operation for more than 21 years. Over 32.7 million policies have been issued by the company to date. For the FY ending March 31, 2023, the company’s Gross Written Premium (GWP) totalled INR 217.72 billion. A total of 3.6 million claims have been settled by ICICI Lombard. The company’s team comprises nearly 12,865 employees (as of March 31, 2023) and it has around 305 branches across India.

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%.

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:

Eligible Age

91 days - 65 years

Coverage

5 Lakh - 3 Cr

ICICI Lombard Health Shield Policy

Starting Premium- NA

Eligible Age

91 days onwards

Coverage

3 Lakh - 50 Lakh

Top Features From ICICI Lombard Health Plans

  1. Complete Coverage for Hospitalisation: ICICI Lombard Health Insurance Plans offer comprehensive coverage to the insured,including for pre- and post-hospitalisation expenses.
  2. 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.
  3. 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.
  4. Critical Illnesses: ICICI Lombard provides health insurance coverage for all critical and life-threatening diseases that generally require longer and costlier treatment.
  5. 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

  1. 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.
  2. Intentional Self-Injury: Suicide attempts or injuries owing to illegal acts are not covered.
  3. 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.
  4. Maternity Complications: Any problems or complexities arising during pregnancy, abortion, childbirth, or miscarriage are excluded from health insurance.
  5. 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.
  6. Dental/Eye Treatments: These are generally not covered under health insurance coverage by ICICI Lombard.
  7. HIV/AIDS: Treatment for these conditions is excluded from the health plans.
  8. Alternative Treatments: Therapies such as Naturopathy, Ayurveda, and Homeopathy are not covered.
  9. 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

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ICICI Lombard Customer Care

Customer Care Number

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
A
fter 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

FAQs

Permanent partial disablement includes loss of one hand, loss of one foot, loss of sight in one eye, loss of hearing in one or both ears, loss of fingers and thumbs of hands and/or feet, loss of individual fingers or toes, etc.

Yes, ICICI Lombard health insurance plans allow coverage for senior citizens too. Both health insurance plans offered by the company, Complete Health Insurance and Health Booster, have no maximum entry age making them suitable for individuals of all ages.

You would need to submit your identity proof, age proof, residence proof and photographs with the application form to buy the policy.

Free health check-ups provided under ICICI Lombard health insurance plans are allowed only for adult members. Under both health insurance plans, free health check-ups are allowed for up to two insured members only.

Yes, your health card would be mandatory if you want to make a cashless claim. Health cards contain your policy details and unique identification number. They allow the hospitals to identify the insured members so that cashless treatments can be provided. So, if you are taking treatments at a networked hospital, carry your health card with you for claim purposes.
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