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ICICI Lombard - Health Insurance Claim Denial for 10-Day Hospitalization at Zenith Super Hospital Without Specific Written Repudiation Rationale

ICICI LombardPC-2026-02870Insurance ClaimsAnonymous ·
I am writing to raise a formal complaint regarding the handling and denial of my wife's health insurance claim under the health insurance policy taken from ICICI Lombard. I purchased the policy on 23 September 2025 by paying a premium of approximately Rs 23,500. My wife was the first/primary insured member and I was the second insured member under the policy. On 3 December 2025, my wife underwent a health check-up through/arranged by ICICI Lombard. Her test reports showed that her creatinine was approximately 5.5 and her urea level was also high. After reviewing the reports, our family doctor advised her to be admitted to a hospital immediately. Following the doctor's advice, my wife was admitted to Zenith Super Hospital, where she remained admitted for approximately 10 days and received medical treatment. When we submitted the hospitalization claim to ICICI Lombard, the claim was denied. When I contacted the ICICI Lombard manager to understand the reason for the denial, I was told only that there was "insufficient information/documents to verify the claim." I specifically asked the manager to clarify: 1. Which particular documents or information were missing? 2. Why was I not clearly informed about the required documents? 3. What specific policy condition or exclusion was relied upon to deny the claim? 4. Why was the claim denied instead of giving us an opportunity to submit the required documents? 5. Please provide the complete written claim repudiation/denial letter with detailed reasons. Despite requesting clarification, I have not received a satisfactory and specific response. I purchased the policy in good faith and paid the premium as required. Therefore, I expect ICICI Lombard to process the claim fairly, transparently and strictly in accordance with the policy terms and applicable insurance regulations. I request ICICI Lombard to:n- Reconsider my wife's claim.n- Provide the complete written reason for the denial.n- Clearly identify every document/information allegedly missing.n- Provide the specific policy clause relied upon for denial.n- Provide copies of the relevant claim assessment/verification records, to the extent permissible.n- Reassess the claim after considering all available medical and hospitalization documents. If the matter is not resolved satisfactorily, I reserve my right to escalate the complaint to the appropriate insurance grievance/ombudsman and regulatory authorities and pursue other remedies available under applicable law.

Reference details

Complainant
***************
Target Entity
***************
Policy Purchase Date
***************
Annual Premium
***************

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  1. Case filed

    System · 24 Oct 2026, 9:21 am

Comments (1)

  • ICICI Lombard (via email)Company

    Received via email from the company's official address · Sender: customersupport@icicilombard.com

    Thanks for getting in touch. We’re on it. Dear Customer, Thank you for reaching out to us. To ensure we address your query effectively, we kindly request you to share any additional information using the following link: **Note: The link will expire in 24 hours** We will provide a response to you within 24 hours. For urgent updates on previous raised queries, connect with us via WhatsApp at ****** from your registered mobile number.

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