ICICI Lombard Claim Form - Pazcare

ICICI Lombard Claim Form

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ICICI Lombard claim form for group mediclaim policy

The ICICI Lombard claim form for your group mediclaim policy contains two parts. ICICI Lombard health insurance Claim form part A, which is filled by the policyholder or the insured. Then comes the claim form part B, which is filled by the hospital in which the treatment was done.

Download the ICICI Lombard claim form

How to fill ICICI Lombard claim form for your group medical policy?

  1. Firstly, intimate the ICICI Lombard group health insurance company about the hospitalisation. The ICICI Lombard claim form can be downloaded from the Pazcare dashboard or from https://www.icicilombard.com/downloads 
  2. Start by filling in your ICICI Lombard insurance policy number followed by the claim number and the TPA Id number. These details are present on your ICICI Lombard group health insurance identity card.
  3. Fill in your personal details like name, address, phone number, state, city and all the necessary details asked in your ICICI Lombard health claim form.
  4. If you are covered by any other health insurance policy, please mention those details under the section “Details of insurance history” in your ICICI Lombard health insurance claim form.
  5. Then fill in the details of the insured person hospitalised and the details of the hospitalisation including the type of room, the reason for hospitalisation and all other necessary details in the ICICI Lombard reimbursement claim form.
  6. Then comes the section where the details of the claim are to be filled in on your ICICI Lombard claim form. This includes pre-hospitalisation and post-hospitalisation expenses, ambulance charges, and other details that are applicable to your ICICI Lombard group health insurance plan offered by your organization.
  7. Enclose the required documents mentioned in your ICICI Lombard insurance claim form. Please check if the originals or photocopies of each document are required and submit them accordingly. Make sure that the documents section on the claim form is ticked according to the enclosed documents.
  8. Finally, fill in the bank account details of the insured along with a cancelled cheque leaf for the ICICI Lombard reimbursement claim for your group medical policy. In this case, one has to also submit a copy of the Aadhar and pan card for all claims.
  9. The ICICI Lombard claim form part B will be duly filled by the hospital in which the treatment was taken.

ICICI Lombard claim form filled sample 

ICICI Lombard claim form filled sample - Pazcare

Star group health reimbursement insurance claim process

After you fill out the ICICI Lombard claim form, here is how you will file for the reimbursement claim.

  1. A reimbursement claim is filed when the insured is admitted to any hospital where cashless treatment is not possible. Such hospitals are called non-network hospitals.
  2. Make sure you collect all the necessary documents to file the reimbursement claim. This also includes all the original copies of hospital bills and a duly filled ICICI Lombard claim form.
  3. Also, make sure you have xerox copies of all the attached original documents for your reference.
  4. You can submit these documents online/offline based on your convenience. For online, they can be carried out through https://ilhc.icicilombard.com/Customer/DocumentUpload this portal.
  5.  The ICICI Lombard claim status can be reviewed on the ICICI Lombard insurance website. Fill in your claim number or AL number to track the claim.

Download the ICICI Lombard claim form

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