ICICI Lombard Health Insurance Claim Ratio

ICICI Lombard is noted for its instant coverage and speedy claim settlement process. It is one of the best insurance providers in the medical insurance industry.

A medical emergency can be overwhelming; it may leave you unable to work and struggling to manage treatment costs. To stay protected, it’s wise to invest in a comprehensive health insurance plan that covers hospital stays, ICU charges, doctor consultations and pre- and post-hospitalisation expenses. However, the policy truly helps only if the insurer offers a smooth claim process and has a high claim settlement ratio. So, choose a reputable insurance company like ICICI Lombard, which is noted for its instant coverage and speedy claim settlement process.

How is CSR calculated?

The claim settlement ratio (CSR) is calculated by dividing the total number of claims settled by the total number of claims received during a financial year and then multiplying the value by 100.

CSR = (Total claims settled / Total claims received) × 100

Why CSR matters when choosing health insurance

The claim settlement ratio (CSR) is an important factor to consider when choosing a health insurance provider because it gives an idea about the reliability of the insurer. A high CSR shows the insurance company approves most claims, making them dependable and credible. This means your claim will more likely be accepted, providing you with peace of mind during medical emergencies.

On the contrary, a low CSR says that the insurer rejects or delays a significant number of claims. This may indicate poor service quality, stricter claim scrutiny or inefficiencies in the claims process. A low CSR makes an insurance company less reliable for policyholders. 

CSR vs ICR: Which one is more important for you?

When choosing a health insurance provider, checking their claim settlement ratio (CSR) and incurred claim ratio (ICR) is important. 

CSR shows the percentage of claims an insurer has settled in a given period, indicating how reliable they are in approving claim amounts. ICR, on the other hand, reflects how much of the collected premium is paid out in claims. It gives insight into the insurer's overall claim settlement speed. However, a good ICR doesn’t guarantee individual claim approval. So, when buying health insurance, it's wise to focus more on CSR to ensure a smoother claim experience.

ICICI Lombard health insurance claim process

You can file a health insurance claim with ICICI Lombard by following these three simple steps:

Initiate: Contact our claim executives as soon as a medical emergency occurs by dialling 1800 2666. You can also request via the IL Take Care App.

Verification: Our claims team will verify the medical documents you shared. If everything checks out, your request will be processed further. 

Tracking: You can track the real-time claim status with just a few clicks on your mobile device, on the IL Take Care App.

Claim procedure for cashless hospitalisation

ICICI Lombard has over 6700+ network hospitals across India, reducing your financial burden during a medical crisis.

• Visit the nearest network hospital. Keep a list of network hospitals handy to avoid the last-minute hassle.
• Go to the health desk counter and show the third-party administrator (TPA) your health card.
• TPA will complete the pre-authorisation request application and submit it on your behalf to the ICICI Lombard claim team.
• The claim executives will review the request form and verify the medical reports before approving the request.
• Once the request is approved, you can avail yourself of treatment for free. 
• Post-treatment, the bills will be settled directly with the hospital.

Note: If the cashless claim is rejected due to missing information or other insignificant reasons, you must pay the bills from your pocket and then file a reimbursement claim.

Claim procedure for hospitalisation expenses reimbursement

You must first review the policy wording before submitting a reimbursement claim to ensure your medical condition is covered by the family health insurance policy. Once confirmed, proceed with the steps below:

• Soon after you are released from the hospital, collect all invoices, discharge letters and medical screening reports.
• Fill out the claim form and upload the documents online. 
• The ICICI Lombard claim team will verify your information. If your details are genuine, your claim will be settled within the next 15 days.
• The reimbursement amount will be determined after taking the co-pay clause into account.

Steps to check the ICICI Lombard health insurance plan claim status

Dial the toll-free number to connect with the support executive team and check the claim status. You can also track the status through the IL Take Care App. Here’s how. 

• Download the IL Take Care App from the Play Store
• On the application's home page, select claims
• Next, enter your policy number
• Click on "Track your claims"
• Choose your claim number and click submit
• Your screen will display the results

Another way to check your status is through WhatsApp. Simply click the WhatsApp icon on the ICICI Lombard website, raise your query and you will be given the necessary information.

Conclusion

ICICI Lombard’s health insurance claim ratio gives you insight into how trustworthy and efficient the company is when handling claims. A strong CSR means you’re more likely to get your claim approved without delays. Always check this before buying a policy, as it helps you choose a reliable insurer.

If you are looking for a health insurance policy from a reliable insurer, fill out the form on this page and get expert help in finding the right plan that fits your needs.

FAQ

• Is the CSR necessary in health insurance?

Yes, because the CSR shows how many claims an insurer has approved in a given period, helping you judge their reliability.

• Is ICICI Lombard’s claim settlement record reliable?

Yes, ICICI Lombard has a strong claim settlement ratio, making it a trusted choice for many.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.