Claims and Wellness Management

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Claims Info


Claim Intimation Procedure

  • Insured or his representative needs to intimate at least 48 hours prior a planned hospitalization and in case of an emergency situation, within 24 hours of hospitalization
  • Insured or his representative to call on toll free no. 1800 2666 or forward an SMS "HEALTHCLAIM" to 575758 to receive call back from ICICI Lombard Health Care
  • Customer provides following information during claim intimation to ICICI Lombard Health Care and receives Claim Intimation Service Request Number as reference number. This reference number should be mentioned in the claim form during claims reimbursement:
    1. UHID Number
    2. Policy Number
    3. Patient Name
    4. Name of Caller
    5. Caller's Contact Number
    6. Relationship with the Proposer
    7. DOA
    8. Expected Length of stay
    9. Reason for Admission
    10. Name of the Doctor
    11. Hospital Name
    12. Hospital complete address with landmark
    13. Hospital City
    14. Hospital State

Note : All the above mentioned details are mandatory to raise claim intimation service request.

Documents Required* (In Originals) Email Documents Required Only

Please take care to submit all the below documents while submitting your reimbursement claim:
  • Duly filled Claim form (signed by the Insured and the Treating Doctor)
  • Discharge summary (with details of complaints and the treatment availed)
  • Final Hospital Bill (detailed break-up) along with interim bills
  • Payment Receipts
  • Doctor's consultation papers
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Documents Required*
Please take care to submit all the below documents while submitting your reimbursement claim:
  • Duly filled Claim form (signed by the Insured and the Treating Doctor)
  • Discharge summary (with details of complaints and the treatment availed)
  • Final Hospital Bill (detailed break-up) along with interim bills
  • Payment Receipts
  • Doctor’s consultation papers
  • All investigation reports (E.g. Original Blood report, X-ray, Sonography, CT Scan,
    MRI, etc.)
  • All pharmacy bills supported by doctor prescriptions
  • Implant sticker / invoice, if used (E.g. lens details in cataract case, stent details
    in angioplasty)
  • Medico Legal Certificate (MLC) and / or FIR for all accident cases
  • For miscellaneous charges - detailed bills with supporting prescription of the
    Treating Doctor
  • Photocopy of Health card
  • Any other related documents

Please note all documents should be in Original.

* This is not an exhaustive list; any other document could be required post assessment of your case.

Standard Payments and Deductions* Email Standard Payments and Deductions

The following are the standard payments under a standard health insurance policy:
  • Accommodation Charges - Room Rent (as per eligibility)
  • ICU Charges (wherever applicable)
  • Treating Doctor fees (E.g.:- Surgeon charges, Visit fees, Consultation fees, etc.)
  • Nursing Charges
  • Anesthesia & Anesthetist charges
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Standard Payments and Deductions*
The following are the standard payments under a standard health insurance policy:
  • Accommodation Charges - Room Rent (as per eligibility)
  • ICU Charges (wherever applicable)
  • Treating Doctor fees (E.g.:- Surgeon charges, Visit fees, Consultation fees, etc.)
  • Nursing Charges
  • Anesthesia & Anesthetist charges
  • Investigation charges
  • Pharmacy bills
  • Consumables
  • Operation Theatre charges (wherever applicable)
  • Implant (s) charges (wherever applicable) – E.g. Stents, Lens, etc.

* This is just an exemplary list; such payments/deduction could vary on Policy Terms & Conditions.

The following are deducted / Not Paid under a standard health insurance policy:
  • Ambulance charges (unless specified in policy)
  • Administration charges
  • Admission / Registration fees, File / Records Management charges
  • Service / Surcharges
  • Bed booking / Reserving charges
  • Food & Beverages
  • Soaps, Toiletries & Laundry
  • Patient’s Attendant charges
  • Special Nurse / Attendant charges
  • Telephone / Photocopy / Courier / Insurance Processing Fees, etc.
  • FIR / MLC charges
  • Others (non-insurance, items not related to treatment)
  • All Items mentioned as exclusions in the policy
An elaborative list of exclusions and deductibles can be found here

* This is just an exemplary list; such payments / deduction could vary on Policy Terms & Conditions.

Points to Remember Email Points to remember

For Cashless Facility:
  • Avail the benefits of cashless service at ICICI Lombard Health Care's (ILHC) network hospitals
  • Kindly ensure that the Pre-Authorisation form is completely filled and signed bythe Insured and the Treating Doctor.
  • Kindly ensure to mention the mobile number on the Pre-Authorisation form
  • In case of planned hospitalisation, please send the Pre-Authorisation form in advance (not before 15 days of admission date) to ILHC.
  • In case of emergency hospitalisation, please send the Pre-Authorisation form within 24 hours from the time of hospitalisation.
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Points to Remember
For Cashless Facility:
  • Avail the benefits of cashless service at ICICI Lombard Health Care's(ILHC)
    network hospitals
  • Kindly ensure that the Pre-Authorisation form is completely filled and signed by
    the Insured and the Treating Doctor.
  • Kindly ensure to mention the mobile number on the Pre-Authorisation form
  • In case of planned hospitalisation, please send the Pre-Authorisation form
    in advance (not before 15 days of admission date) to ILHC.
  • In case of emergency hospitalisation, please send the Pre-Authorisation form
    within 24 hours from the time of hospitalisation.
  • In case of cashless denial, Insured to pay hospitalisation expenses
  • Quote your Cashless (Pre-Authorisation) number as reference in all future
    correspondence with ILHC
  • Do not refer the network list of any other service provider
  • Do not wait until the discharge time to raise the enhancement request

For Availing Reimbursements:
  • Mention correct and complete communication address with the pin code on
    the claim form
  • Always keep a photocopy of the claim documents submitted to ICICI Lombard
    Health Care (ILHC)
  • Kindly ensure that the Claim form is completely filled and signed by the Insured
    and the Treating Doctor
  • Kindly ensure to mention the mobile number on the Claim form
  • All claim documents are to be submitted in original within 30 days from the date
    of discharge
  • Quote your claim number as reference in all future correspondence with ILHC

Day Care Surgeries

Day care surgeries does not require 24 hour hospitalization Please click here to view the list of Day Care Surgeries


Email Complete claims information





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