ICICI Lombard Claim Settlement Ratio
Choosing the best health plan can be difficult, but choosing the best health insurance company can be even more difficult. Choosing the best health insurance company for you and your family can be difficult when there are more than 20 of them, each claiming to provide the best insurance services. Thus the claim settlement ratio is an important factor that should be considered while selecting an insurance provider from whom to buy insurance.
This aspect will make the selection procedure easier for you and assist you in understanding the company's performance. The purpose of getting a health insurance plan is completely lost if the claims are not settled. So, it is crucial for you to check the claim settlement ratio of each health insurance company before making a final decision.
According to the Annual report of IRDAI (2021-22), the ICICI Lombard health insurance claim settlement ratio is 97.07.
In the below section, we will discuss the ICICI Lombard Health Insurance Claim Settlement Ratio and its importance
What is ICICI Lombard Health Insurance Claim Settlement Ratio?
As per IRDAI, ICICI Lombard has a claim settlement ratio of 97.07 in the year 2021-22. The claim settlement ratio is a percentage of the total claim settlement by a health insurance company in a financial year. Simply put, the percentage of total claim settlement upon the total claim filled in a financial year.
Formula to calculate ICICI Lombard Health Insurance: Total number of claims settled/Total number of claims received * 100
ICICI Health Insurance Claim Settlement Ratio
ICICI Lombard Health Insurance claim settlement ratio is 97.07%. Take a look at the below table for insight and get an idea of the ICICI Lombard Claim Settlement Ratio
| ICICI Lombard Health Insurance Claim Settlement Ratio (2021-22) | ||||||
|---|---|---|---|---|---|---|
| Number of Claims Paid (%) | < 3 months | 3 months to 6 months | 6 months to <1 year | 1 year to < 3 years | 3 years to < 5 years | 5 years |
| Claims Settled | 97.07 | 1.69 | 0.59 | 0.37 | 0.12 | 0.17 |
Network Hospitals
Why is Claim Settlement Ratio Important?
One of the most useful metrics to show how many claims a company settles in a financial year is the claim settlement ratio. This is an important factor that helps you evaluate how quickly the company will settle your claims in case of an emergency. Before buying a health insurance plan, always check the history of claims that the health insurance company has settled.
The claim settlement ratio can be used by potential buyers to determine how well a health insurance company handles claims. It is recommended to check the claim settlement ratio of all the health insurance companies before buying a health insurance plan from any health insurance company.
Claim Processes Offered by ICICI Lombard Health Insurance
ICICI Lombard health insurance offers two types of claim processes:
- Cashless Claim Process
- Reimbursement Claim Process
Cashless Claim Process
Cashless claims in health insurance are a type of hospitalization in which policyholders do not need to pay any amount to the hospital after taking the treatment and the health insurance company will directly settle the bill with the hospital. Below mentioned is the process to file a cashless claim:
- Get admitted to one of the network hospitals of ICICI Lombard health insurance
- Intimate the ICICI Lombard Health Insurance about the hospitalization.
- Fill out the pre-authorization form and submit it to the hospital.
- The hospital will send the pre-authorization form to ICICI Lombard Health Insurance Company for approval.
- Once the pre-auth form is approved, the customer can get the medical treatment.
- Pay for any non-medical and inadmissible expenses at the time of discharge.
- The ICICI health insurance will directly settle the bill amount with the hospital.
Reimbursement Claim Process
You can also seek medical treatment at any non-network hospital. Here, you can receive medical treatment in a hospital, pay for it out of pocket, and then submit a reimbursement claim to the health insurance company. It may take a little longer to process as ICICI Lombard Health Insurance Company has to approve them before processing the claim.
- You need to inform ICICI Health Insurance within two days. Then, they send you an online link where you can upload the soft copies of all the original documents, such as bills, reports, discharge summary, etc. and bank details of your desired bank account.
- Duly signed the documents before uploading them.
- You will receive the reimbursement amount within 30 days of claim submission.
