A complete walkthrough of the ICICI Lombard health claim process.
Written by Harsh SoniReviewed by Shadab SayeedUpdated nyvo insurance Services LLP, IRDAI Corporate Agent (Composite) CA1085Salaried advisors, no commission-based ranking
ICICI Lombard is one of India's largest private general insurers, with a digital-first health claim process – pre-authorisation and reimbursement are both handled online – backed by a 24/7 claim helpline (1800 2666). This guide covers the full workflow – cashless at network and Cashless Everywhere hospitals, reimbursement, and the escalation path if a claim is delayed or contested.
Pull your policy schedule – policy number, sum insured, members covered and plan name (Elevate, Health AdvantEdge, iHealth Plus / Complete Health Insurance) – and save the digital health card from the icicilombard.com portal; the hospital insurance desk asks for it at admission. Confirm chronic-condition disclosures (diabetes, hypertension, thyroid, cardiac history): voluntary disclosure via customersupport@icicilombard.com is treated far better than one forced during a claim review. Network depth varies by city, so verify your preferred hospitals on the hospital locator before relying on them.
For planned admissions, call 1800 2666 at least 48 hours ahead with the policy number, hospital, procedure and cost estimate; the hospital insurance desk submits the pre-auth and ICICI Lombard settles directly at discharge, with final authorisation due within 3 hours of the hospital's discharge request. In an emergency the patient is admitted first and the desk files the pre-auth within 24 hours – you pay only the standard refundable hospital deposit while treatment proceeds. If pre-auth stalls past the IRDAI SLA, call the helpline with the pre-auth reference and ask for a priority review.
Under the General Insurance Council's Cashless Everywhere initiative (24 January 2024), ICICI Lombard processes cashless treatment at hospitals outside its network too, where the hospital has at least 15 beds and is registered under the Clinical Establishments Act. Call 1800 2666 before you admit – at least 48 hours ahead for planned treatment, within 48 hours of admission in an emergency – and ICICI Lombard issues a guarantee of payment to the hospital once the pre-auth is approved. Settlement at discharge works like a network claim, and later claims at the same hospital typically run faster.
Paid out of pocket, or cashless was denied at the counter? File online via the icicilombard.com claim portal, by post to the ICICI Lombard claims processing centre, or at a branch – within the filing window on your policy schedule and with the full document set below. ICICI Lombard must settle the claim within 15 days of submission, under IRDAI's rules.
Once a claim is registered, ICICI Lombard General Insurance Co. Ltd. gives it a claim or intimation number, and that number is what every status channel asks for. Keep it with the policy number and track the claim on the ICICI Lombard claims portal, or call 1800 2666. A cashless request usually moves within hours; a reimbursement claim is measured in days, and the insurer has 15 days from the last document to decide, or 45 where it orders an investigation.
If the status has not moved for several days, or it reads “query raised” without anyone telling you what is missing, that is the point to stop waiting and start the escalation ladder. A query is not a rejection – it is a request for a document, and claims are lost by leaving them unanswered.
Cashless treatment only works at a hospital inside ICICI Lombard General Insurance Co. Ltd.’s network, so check yours before you need it rather than at admission. Search the ICICI Lombard network hospital list by city and pin code, and confirm the hospital is listed for your plan – network depth varies by city, and a hospital can be in-network for one insurer and not another.
If your hospital is not on the list, you are not out of options. Under the General Insurance Council’s Cashless Everywhere initiative (24 January 2024), cashless treatment can be arranged at a hospital with at least 15 beds registered under the Clinical Establishments Act, provided the insurer is told in advance – 48 hours before a planned admission, or within 48 hours of an emergency one.
The 24/7 cashless and claim helpline is 1800 2666. Email queries go to customersupport@icicilombard.com, and the icicilombard.com claim portal handles claim filing, status tracking and document upload – keep your policy number and claim reference handy for the fastest response.
Under IRDAI's rules, a cashless request is decided within 1 hour, planned or emergency; final authorisation at discharge comes within 3 hours; and a reimbursement claim is settled within 15 days of submission (Master Circular on Health Insurance Business, 29 May 2024; Master Circular on Protection of Policyholders' Interests, 5 September 2024).
Most counter denials are reversible. Get the denial in writing, call the helpline, and ask whether the claim can be re-submitted with additional documentation from the treating doctor. If the denial is final, switch to the reimbursement track – pay the bill, keep the denial letter and file post-discharge. Full plan: Cashless Pre-Auth Denied Playbook.
The same cashless and reimbursement workflow applies across ICICI Lombard's health plans – Elevate, Health AdvantEdge and iHealth Plus / Complete Health Insurance. Plans differ in sub-limits, room-rent terms and waiting periods, not the claim process – your policy schedule is the source of truth for plan-level caps.
16+ years in financial services. Former investment banker at Bank of America, Kotak Investment Banking, and SBICaps, and ex-CFO of slice. Founder of nyvo and Principal Officer – IRDAI Certified.
If you hold one of these, or are deciding between them, each page is read out of ICICI Lombard's own policy wording – waiting periods, room rent, exclusions and where the plan falls short.
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