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Claiming health insurance without breakup in bill

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05 Jul, 2022 by  Chethan S

I have to file a maternity claim with ICICI Lombard Health Insurance (Corporate Policy) and the claim form requires amounts to be filled under various heads. However, the hospital (a small one), has given me one single bill stating "Package" for the whole amount.

There is no breakup of any kind - no separate room, doctor, procedure charges printed. I only have separate bills for medicines and some lab tests.

I did ask for a breakup but they don't seem to have a system to generate such a bill. Now, if I add the amount under "Miscellaneous/Other charges" how would the company consider it?

Health Insurance

1 Answer

06 Jul, 2022
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Hi Chethan,

Many a time, members who get treated in non-network hospitals face such challenges, especially if the hospital has no proper infrastructure or billing mechanism. You can choose to do one of the following:

  1. Request the treating doctor to at least give a tentative breakup of the expenses incurred on the hospital letterhead or prescription
  2. Take a declaration from the hospital that itemized billing procedure is not being followed & that they charge the total bill on the name of a package instead.

Do not forget to collect the receipt for the total amount paid & submit the claim with ICICI Lombard.

And about mentioning the amount details against the Miscellaneous/Other charges, do not worry about it. You can still mention the details under the total claimed amount section.

Also, make sure that the Part-B of the claim form has Hospital's Stamp & Signature before submitting the claim.

Since you have a Corporate Policy, chances are high that the maternity claim gets approved under such exceptional circumstances.

Best Wishes,

Satish Kumar H

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06 Jul, 2022
Chethan S
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