ICICI Lombard Claim Settlement Ratio

Choosing an ideal health plan is tedious; however, opting for the right health insurance provider is more challenging. With more than 20 health insurance companies claiming to offer the best services, selecting the best one for you and your family can be quite confusing. So, one of the significant criteria to consider when choosing an insurance company from which to purchase insurance is the claim settlement ratio.

This factor not only helps you to understand the company’s performance but will also smoothen the selection process. If the claims are not resolved, the entire point of purchasing insurance coverage is defeated. Thus, before zeroing down on your choice of one insurance company, you need to check the company’s claim settlement history.

In the section below, let us explore the ICICI Lombard Claim Settlement Ratio, and discuss its importance:

According to Claim statistics for FY 2025, computed based on the number of individual claims settled (paid) over the total number of individual claims within 30 days, ICICI Lombard’s health insurance claim settlement ratio is 97.16%.

Let us get a better understanding of the ICICI Lombard Claim Settlement Ratio

Types Of ICICI Lombard Health Insurance Claims

There are two types of health insurance claims you can choose from

• Cashless Claim
• Reimbursement Claim

What Are Cashless Claims?

Cashless claims in health insurance are a mode of claim settlement in which the policyholder does not have to pay cash for treatment. The settlement of the bills is handled directly between the hospital and the insurance company. ICICI Lombard’s cashless claim settlement helps pay off the hospital bill instantly, upfront. Cashless claims are gaining popularity every day, and more and more people getting health insurance policies are availing of this feature for the comfort it offers.

Here’s How You Can File Your Cashless Claims Online

Step 1: Find the network hospitals of ICICI Lombard Health Insurance and get admitted to only those hospitals that fall into the network of your insurer.

Step 2: Now, notify ICICI Lombard Health Insurance Company about the hospitalization. In case of pre-hospitalization inform the insurer about the hospitalization prior to getting admitted.

Step 3: The customer needs to fill out the pre-authorization form and submit it to the hospital. The pre-authorization form is then sent for approval to ICICI Lombard Health Insurance Company. Once the form is approved, the customer can avail the medical treatment.

Step 4: At the time of discharge fill in all the medical documents and pay for the services that are not covered under the policy.

Step 5: The hospital will send the hospital bills to ICICI Lombard Health Insurance Company. After review the company will pay the bill directly to the hospital.

ICICI Lombard’s claim process is simple and app-based, making your experience hassle-free. You can contact the company to file a claim, submit your documents, and check your claim status easily on the IL Take Care app.

What Are Reimbursement Claims?

Reimbursement Claims

In this type of claim, you can visit any hospital, not just those under your insurer’s cashless network. Here, you get your treatment done at the hospital, pay out of your pocket, and then apply for reimbursement for the expenses with your insurer. At the time of making the claim, the customer needs to submit all hospital bills, prescriptions, and medical documents. These will need to be approved by ICICI Lombard Health Insurance Company before the claim is processed, meaning that it can take slightly more time to get through.

Here’s How You Can File Your Reimbursement Claims Online

Step 1: You need to call ICICI Lombard Health Insurance within two days of your admission date. Post the company’s call, they send you a link where you can upload the soft copies of all original documents (bills, reports, etc) and bank details of your desired bank account.

Step 2: Before uploading, you need to sign all the documents yourself.

Step 3: Upload the documents maximum within 30 days from the date of discharge or when you receive the link.

Step 4: You will receive the payment within 30 days from the receipt of the last necessary claim document.

ICICI Lombard Health Insurance provides a 15-day grace period for reimbursement claims. If the documents have not reached the company post this grace period due to an inadvertent delay, you can contact the company with the explanation for the same and resend/re-upload the documents.

Why Is Claim Settlement Ratio (CSR) Important?

The claim settlement ratio is one of the most useful parameters that showcases the number of claims settled by the company in a financial year. It is an important factor that helps you to evaluate how soon the company will settle your claims in the time of need. Before buying health insurance, one should always check the history of claims settled by that company.

Prospective buyers might use the claim settlement ratio to determine how well the insurance company honours their claims. It is recommended to check the claim settlement ratio of all the plans having the lowest premiums and highest benefits.

A higher health insurance claim settlement ratio indicates the company’s financial performance and its ability to pay off the claims made by its customers.

Conclusion 

In conclusion, ICICI’s claim settlement ratio for the year 2025 is a robust 97.16%, demonstrating a strong commitment to fulfilling its policyholder obligations. This high ratio not only reflects operational efficiency and financial stability but also instils significant confidence in customers seeking reliable insurance coverage. For policyholders, this figure serves as a key indicator of ICICI’s dependability and reinforces its position as a trustworthy insurance provider in the market.

To stay up to date with ICICI Lombard Health Insurance developments talk to PolicyX insurance experts. 

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