ICICI Lombard Health Care Claim Form - Hospitalization PDF

PDF Name	ICICI Lombard Health Care Claim Form – Hospitalization
No. of Pages	6
PDF Size	0.36 MB
Language	English
PDF Category	General
Source / Credits	Multiple Sources
Uploaded By	Pradeep

ICICI Lombard Health Care Claim Form – Hospitalization - Summary

This is the ICICI Lombard Health Care Claim Form for hospitalization, which you can use to file your health care claims issued by ICICI Lombard. You can easily get this form from the nearest ICICI Lombard branch or download it from the link below.

How to Fill the ICICI Lombard Health Care Claim Form

It’s important to provide accurate details to ensure your claim is processed quickly. Here are the essential details you need to mention in the ICICI Lombard Health Care Claim Form:

Details to be Mentioned in ICICI Lombard Health Care Claim Form

Details of the Insured person
Type of Claim
Nature of disease/ illness contracted or injury suffered for which the Insured was hospitalized
Details of Claim
And any other relevant documents

Documents Required

Claim form duly filled (Original)
Discharge Summary/ Daycare Summary (Original)
Final Hospital Bill (Original)
Payment Receipts (Original)
Investigation Reports (Original)
Pharmacy Bills (Original)
Implant Sticker/ Invoice (Original)
Doctor Prescriptions (Photocopy)
Consultation Paper (Photocopy)
Age Proof (Photocopy)
Indoor Case Paper (Photocopy)
EFT (Copy of canceled cheque/self-attested ID proof/ Bank-attested copy of passbook with IFSC code)
And any other necessary documents

You can download the ICICI Lombard Health Care Claim Form for Hospitalization in PDF format using the link given below. This will help you prepare your claim easily and quickly! 🏥

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