Get Icici Lombard Claim Form

Filing an Icici Lombard Claim Form online can simplify the claim process and ensure you submit all necessary information. This guide will walk you through each step of the form to make it as straightforward as possible.

Follow the steps to complete your claim form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin filling out Part A of the form in capital letters. Enter the policy holder's name or proposer’s name, current policy number, card number, Aadhaar number, and PAN number as applicable.
3. Select whether the policy is an Individual/Retail Policy or a Group/Corporate Policy. If it's a Group/Corporate Policy, provide the company name and your employee ID.
4. Provide the details of the insured person for whom the claim is being made, including their name, relationship with the policy holder, occupation, age, gender, and contact information.
5. Specify the nature of the disease or injury for which the claim is being made. Include a detailed diagnosis.
6. Fill in the date when the treatment commenced and provide the name and contact details of the treating doctor.
7. List the details of the amount claimed. Include bill numbers, dates, types of charges (consultation, pharmacy, investigations), and ensure that the total claimed amount matches the attached documents.
8. In Part B, indicate the documents you are enclosing to support the claim. Ensure all required originals and copies are included.
9. In Part C, provide bank account details for the purpose of electronic fund transfer. This will include providing necessary identification for the proposer or policy holder.
10. Read and acknowledge the declaration at the end of the form, confirming that all information provided is true and complete.
11. Finally, save any changes. You can download, print, or share your completed form as needed.

Complete your Icici Lombard Claim Form online today to ensure a smooth claims process.