ICICI Prudential Claim Settlement Ratio

ICICI Prudential Claim Settlement Ratio

ICICI Prudential is one of the leading life insurance companies in India with a PAN-India presence. Its life insurance products are customized to address the emerging needs of customers. But do you know about its claim settlement ratio? No! We will let you know about it. Firstly, a claim settlement ratio helps you know about how much claims the particular insurance company settles in a financial year. Although the claim settlement ratio is not the sole factor when deciding to choose an insurance plan from ICICI, knowing it will at least help you get an impression of the insurer. Read on to know more about it.

What is a Claim Settlement Ratio?

The claim settlement ratio is published every year by the Insurance Regulatory and Development Authority of India (IRDAI), and the claims settlement ratio of ICICI Prudential for the financial year 2019-20 is 97.8%. This claim settlement ratio is calculated based on individual claims settled over the total individual claims in that financial year. You can also check the IRDAI annual report online to find the claim settlement ratio.

ICICI Prudential Claim Settlement Ratio Consistency

To find out more about the ICICI Prudential claim settlement ratio, you can check its claim settlement history. Check out the table below to know the ICICI Prudential Claim Settlement Ratio of previous years.

With over 90% claim settlement record over 12 financial years, ICICI Prudential has made a name for itself in the insurance space.

ICICI Prudential Life Solvency Ratio in 2018-19

When you know the insurance company’s solvency ratio, it will help you find the insurance company’s financial situation. The IRDAI maintains the record of companies’ solvency ratio in the annual report where also the claim settlement ratio is mentioned. Check out this table below and know what is ICICI Prudential Life Solvency Ratio for the financial year 2018-19.

ICICI Prudential Three Step Claim Process

If you want to claim your ICICI Prudential policy,  follow these three steps:-

Step 1:- Claim Reporting

In the first step, you need to report the claim that you can do either online or offline at our branch as per your convenience. The claim is formally registered if you submit a written request to the company at its branch or Claims Cell office. For further information, you can dial 1-860-266-7766, SMS to 56767 with ‘ICLAIM<space>Policy Number’, send an email to claimsupport@iciciprulife.com 

Step 2:- Claim Processing

ICICI Prudential Life ClaimCare team scrutinizes your claim details and will guide you, individually, at every step. It will assess your claim, inform you if any documents are pending and raise a requirement. The company’s claim experts will guide you and make sure that you get help whenever you need it. To track your claim status, you can call the helpline number 1-860-266-7766 or visit the nearest branch and ask for help at the Priority Claim Desk.

Step 3:- Claim Settlement

Once the claim is intimated to the insurer, and it receives all the relevant documents, ICICI Prudential Life will settle your claim.

What Documents are Required for ICICI Prudential Life Claim?

The claim documents will depend on the type of claim you have filed. You will need to submit the following documents.

Life Insurance Claim

1. Duly filled claim intimation form with all details (the form is available in the claims section of ICICI Prudential Life official website, www.iciciprulife.com)
2. Original ICICI Prudential Life Policy Certificate
3. Death Certificate issued by the local authority
4. Copy of Photo Identity proof and Current Address proof (Nominee)
5. Copy of Cancelled cheque, Bank statement, or Passbook (Nominee)

 Critical Illness Claim

1. Duly filled claim intimation form with all details (the form is available in the claims section of ICICI Prudential Life official website)
2. Original ICICI Prudential Life Policy Certificate
3. Copy of  medical records (such as medical reports, case histories, investigation reports, treatment papers, or discharge summaries)
4. Letter from your treating doctor to confirm the diagnosis of the ailment for which the claim is being filed
5. Copy of Cancelled cheque of the bank account where you wish to receive the claim amount

You can submit all theses documents through the following modes:-

1. Upload the documents online on the ICICI Prudential Life website
2. Submit the documents at ICICI Prudential Life claim desk available at any of its branches.
3. Or you can courier the documents to ICICI Prudential Life Insurance Co. Ltd., 1st Floor, C Wing, Office No. 115, 116, 117, BSEL Tech Park, Opp. Vashi Station, Sector 30 Vashi, Navi Mumbai – 400706.

When ICICI Prudential Life has received all the required documents, it will evaluate the claim request and communicate its decision within 30 days. If your claim is paid, it will be counted under the ICICI Prudential claim settlement ratio.

When ICICI Prudential Life Rejects a Claim?

To determine the reliability of a claim, the insurer conducts a verification process from time to time. It helps the company identify fraudulent claims made by policyholders. Take a look at the pointers below and know in what scenarios your ICICI Prudential claim could be rejected.

1. If you are suffering from a condition that you do not inform the insurer in the proposal form, it will go down as non-disclosure and can result in claim rejection.
2. If you state that you are salaried but do not mention that your job is highly hazardous, it is a misstatement and can lead to claim rejection.

It is advised that you should write to the Grievance Redressal Committee within 30 days of receiving the reason for rejection of the claim. After careful evaluation of the matter, the committee will decide on the representation made by the claimant within 30 days of receipt. If you feel that the response is not satisfactory, you can approach the Office of Insurance Ombudsman for a re-examination. Also, you can approach Consumer Forums for grievance redressal.

On claim rejection, the list of rejected claims will be excluded from the ICICI Prudential claim settlement ratio.

Micro Insurance Products of ICICI Prudential Life as at 31.03.2019

As per the IRDAI annual report, ICICI Prudential Life has launched the following products in the financial year 2019.

ICICI Pru Sarva Jana Suraksha

It is a non-linked, non-participating term micro-insurance plan that gives security to the policyholder and their family at affordable premiums. If the policyholder dies in an unfortunate event during the policy term, the nominee shall receive the sum assured amount. The death claim would either be 7X your annualized premium amount or 105% of all the total premiums received as on date of death, whichever is higher. The absolute amount assured, which will be paid on death, is the basic sum assured as chosen by the policyholder.

ICICI Pru Anmol Bachat

This ICICI Term Insurance plan provides you with dual benefits of savings and protection. It helps you achieve your goals with the comfort of a guarantee and a life cover. Under this plan, you can choose a premium payment term based on your needs and get the following benefits:-

1. Guaranteed Maturity Benefit (GMB): Payable at the end of the policy term
2. Death Benefit: Payable on the death of the life assured during the policy term

ICICI Pru Shubh Raksha One

It’s a Group Micro-Insurance Plan that offers protection to the members of a group in the case of an unfortunate event at a nominal cost. It provides flexibility, coverage and benefit options as per the needs of the group members. Let’s take a look at the policy benefits.

1. Single and Joint Life cover
2. Convenient Premiums (pay fortnightly, monthly, quarterly, half-yearly, yearly, or single pay)
3. The death benefit is payable on the death of the covered member and equals the Sum Assured.
4. The accidental death benefit will be payable on the death of the member due to an accident. It is the Sum Assured that can be chosen by the member provided this AD Benefit is opted by the Master Policyholder and this will be equal to or less than the base Death Benefit Sum Assured.
5. Accelerated terminal illness benefit is for all new members under the scheme. Under this benefit, if you are being diagnosed with a Terminal Illness, a sum assured amount equal to the Death Benefit will be payable. And this benefit will not be in addition to the Death Benefit.
6. In case the Master Policyholder surrenders the policy, the members can still get the option to continue the cover until the expiry of the policy period. You can surrender your cover anytime during the coverage term. On voluntary surrender, you may have the option to continue or discontinue the cover. If you discontinue the cover, the unexpired risk premium as the Surrender value, if applicable, will be payable.

Once the benefits are paid, the member’s cover will terminate and all rights, benefits, and interests under this policy will stand extinguished.