Claims Guide

ICICI Lombard Health Insurance Claim Guide

A complete walkthrough of the ICICI Lombard health claim process.

HS
Written by
Harsh Soni
Updated 22 June 2026 · 7 min read

The claim process at a glance

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 (1800-266-6). 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.

1–3 hours
Cashless authorisation (IRDAI SLA)
3 hours
Final authorisation at discharge
30 days
Reimbursement decision window

The step-by-step cashless workflow

1

Verify your policy before you need it

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.

2

Cashless at a network hospital

For planned admissions, call 1800-266-6 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 complete documents. 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.

1–3 hr cashless authorisation
3

Cashless Everywhere (non-network)

Under IRDAI's Cashless Everywhere mandate (January 2024), ICICI Lombard processes cashless treatment at any hospital registered under the Clinical Establishments Act. Call 1800-266-6 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.

Allow 1–3 hrs extra first time
4

Reimbursement, if cashless wasn't used

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 decide the claim within 30 days of receiving complete documents.

How to check your ICICI Lombard claim status

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 1800-266-6. 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.

  • Online: www.icicilombard.com/health-insurance/health-claim/ - sign in with the policy or claim number.
  • Phone: 1800-266-6 - fastest route when a hospital is waiting on an authorisation.
  • Email: customersupport@icicilombard.com - put the claim number in the subject line so it threads to the right file.
  • At the hospital: for a cashless claim, the insurance desk can see the authorisation status on the TPA portal before you can.

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.

Reimbursement document checklist
Filled & signed reimbursement claim form
Original itemised hospital bills
Signed discharge summary
All investigation reports
Pharmacy bills with prescriptions
Doctor's consultation notes
Photo ID (Aadhaar / PAN)
Cancelled cheque for refund
Policy copy or e-card
Pre-auth denial letter (if any)
Filing window: commonly 15–30 days from discharge – verify on your policy schedule.

ICICI Lombard cashless hospital list

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 IRDAI’s Cashless Everywhere mandate (January 2024), cashless treatment can be arranged at any hospital 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.

If your claim is delayed: the escalation ladder

L1
Direct contact with ICICI Lombard
Call 1800-266-6 or email customersupport@icicilombard.com with your claim reference. Most issues resolve here.
L2
ICICI Lombard Grievance Cell
Raise a grievance via icicilombard.com → Grievance Redressal. The insurer must acknowledge within 3 working days and resolve within 15.
L3
IRDAI Grievance Portal
File at bimabharosa.irdai.gov.in if the insurer's response is unsatisfactory.
L4
Insurance Ombudsman
File at cioins.co.in within one year of the final response. Decision within 90 days, binding on the insurer up to ₹30 lakh – see our IRDAI Ombudsman guide.
Free claims support

Need a hand with your ICICI Lombard claim?

Review your policy for waiting periods & sub-limits
Coordinate with the helpline if pre-auth is delayed
Draft the grievance letter if escalation is needed
Audit the discharge bill for inflated line items
Walk you through reimbursement filing
Guide you through the Ombudsman filing

Garud answers instantly, any time. A NYVO advisor takes over during working hours.

Where is your claim right now?

Frequently asked questions

The 24/7 cashless and claim helpline is 1800-266-6. 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.

Per the IRDAI Master Circular 2024: cashless authorisation within 1–3 hours; final authorisation within 3 hours of complete documentation; reimbursement decided within 30 days of complete documents.

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.

HS
Harsh Soni
Founder, NYVO · Principal Officer, IRDAI Certified

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.

Sources: ICICI Lombard General Insurance Company Limited official claim documentation, icicilombard.com (helpline numbers and process verified June 2026); IRDAI Master Circular on Health Insurance Business, 29 May 2024; IRDAI Cashless Everywhere Circular, 23 January 2024; Council for Insurance Ombudsmen, cioins.co.in. Educational content only – refer to your policy document before making decisions.

ICICI Lombard plans we have read

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.

See all 157 plans we have broken down →

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