ICICI Prudential Life Insurance Claim Settlement Ratio

ICICI Prudential Life Insurance Company Limited is one of India’s leading life insurance providers, founded in 2000 as a joint venture between ICICI Bank and Prudential Corporation Holdings. Headquartered in Mumbai, the company offers a wide range of products, including term plans, ULIPs, endowment policies, retirement plans, and more. Notably, it became the first Indian life insurer to be listed on the stock exchanges in 2016. With a strong presence across the country, ICICI Prudential continues to play a pivotal role in securing India’s financial future.

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What is the Claim Settlement Ratio (CSR) in Term Insurance?

The Claim Settlement Ratio (CSR) is a key indicator that shows how many claims an insurance company successfully pays out compared to the total number of claims it receives in a financial year. Simply put, it tells you the likelihood of your nominee receiving the claim amount if something happens to you.

A higher CSR usually signals a more dependable insurer. For example, if a company receives 100 claims and settles 99 of them, its CSR is 99%. That’s a strong sign of trustworthiness.

Generally, a CSR of 97% or higher is considered excellent. But don’t let a high CSR be the only deciding factor. Some insurers may boast impressive CSRs, but they come with downsides—like expensive premiums, a history of customer complaints, stricter eligibility conditions, or limited policy flexibility.

So, when choosing a term plan, use CSR as one of several criteria. Look at policy features, pricing, rider options, and how transparent and smooth their claim process really is.

How is the Claim Settlement Ratio Calculated?

The formula for calculating CSR is straightforward:

CSR = (Total Claims Settled / Total Claims Received) × 100

For example, if an insurer received 10,000 claims in a year and paid out 9,900, the CSR would be:

CSR = (9,900 / 10,000) × 100 = 99%

While CSR is a crucial indicator, it shouldn't be the only factor you rely on when evaluating a term insurance provider. It's equally important to look at the Claim Rejection Ratio (the percentage of claims that are denied), the Claim Settlement Time (how quickly the insurer processes claims), and the overall transparency of the process—how clearly they communicate requirements and how easy it is to file a claim. 

You should also check the Amount Settlement Ratio, which reflects the actual proportion of the claim amount paid out, the complaint volume, and of course, the premium costs, since affordability plays a key role. Aim for insurers with a CSR of 97% or higher, and steer clear of those with a CSR below 90%, as they may have a higher tendency to reject claims. Also, be cautious if an insurer reports a CSR of over 100%, as it could indicate they're clearing backlogged claims from previous years—something that deserves a closer look.

ICICI Prudential Claim Settlement Ratio 2024

Here’s a list of the top 10 life insurance companies based on their claim settlement ratio (CSR):

As is evident, ICICI Prudential does not rank among the top 10  life insurers in India. Although not a great ranking, their Claim Settlement Ratio is more than 97%, which is excellent considering we took the last three years’ average and ranked insurers based on this. 

Takeaways from the 2024 CSR: ICICI Prudential’s CSR was not above the industry average from 2021 to 2024. However, they picked up their CSR massively in 2023-2024, which is certainly a good sign for policyholders.

Comparison Table: ICICI Prudential CSR Over the Years

*Data sourced from Insurer Website and Statistics Handbook on the IRDAI website

How Does ICICI Prudential Ensure a Smooth Claim Settlement Process?

ICICI Prudential has made the claim process accessible and straightforward online and offline. Here’s how you can initiate a claim online:

Visit the official ICICI Prudential Life Insurance website, and go to the ‘Claims’ section at the top of the homepage.

Click on ‘Report a Claim’ and fill in the online claim form with details like policy number, date of death, claimant’s name, and contact details.

Upload the necessary documents:

• Duly filled Claimant Statement Form
• Recent photo of the claimant
• Government-issued Death Certificate of the Life Assured
• Claimant’s photo ID and address proof (Aadhaar, Passport, Voter ID, etc.)
• PAN card or Form 60 of the claimant
• Cancelled cheque/bank passbook copy
• Duly filled payout mandate form

Cause-specific documents:

• For natural/medical deaths: Medical cause of death certificate, hospital records, treating doctor’s certificate, etc.
• For accidental deaths: FIR, Postmortem Report, Final Investigation Report, etc.

Once submitted, you can track your claim status directly on the website.

If the nominee has passed away, legal heirs can file the claim by submitting documents such as a Death Certificate of the nominee, Succession Certificate, Will, or a notarized indemnity with legal heir certificate.

Claim Process for ICICI Prudential Life Insurance

You can report a claim through any of the following touchpoints:

• Website: Use the online claims section to initiate and track your claim using this link: https://buy.iciciprulife.com/buy/psClaimStatus.htm?execution=e3s1
• Phone: Call the 24x7 ClaimCare helpline at 1800 266 0066.
• Email: Send your documents and claim intimation to claimsupport@iciciprulife.com 
• WhatsApp: Text “Claim” to 9920667766 to start the claim process.
• SMS: Send “ICLAIM <Policy Number>” to 56767.
• Branch Visit: Visit any ICICI Prudential Life Insurance branch for in-person assistance.

If you prefer doorstep document pickup (within India) for death/health/group claims, email claimsupport@iciciprulife.com or call the number above.

Factors Affecting ICICI Prudential Claim Settlement Ratio

If all documents are in order, ICICI Prudential typically settles claims within 30 days, in line with IRDAI regulations. In cases where the insurer needs to conduct further investigation—such as deaths under suspicious circumstances or early claims—the process can take up to an additional 90 days. However, delays can still occur, and here are a few common reasons why. Knowing these in advance can help you respond proactively or escalate the matter if needed:

1. Underwriting at the Time of Policy Issuance: ICICI Prudential, like any life insurer, assesses multiple risk factors—such as age, health conditions, occupation, and lifestyle—before issuing a policy. If a claim appears to contradict the original disclosures made during this assessment, it may be flagged for additional review. For instance, policies issued with limited underwriting (no medical tests or basic disclosures) may attract deeper scrutiny, especially if the claim arises early in the policy term or involves a pre-existing condition that wasn’t declared.
2. Insurer’s Operational Strength & Financial Stability: ICICI Prudential is one of the leading life insurers in India, backed by strong financials and a healthy claim settlement ratio (CSR). A solid solvency ratio and operational efficiency enable them to handle high volumes of claims efficiently. However, in rare instances where there is pressure on operational resources or in case of large claim volumes, even well-established insurers may experience temporary delays in processing complex or high-value claims.
3. Incomplete or Inconsistent Documentation: One of the most common causes of delay is missing or improperly filled documents. For instance, if the death certificate, claimant’s ID proof, or bank account details are incomplete or unclear, the insurer will pause processing until those documents are corrected. If the death was due to an accident or involved legal proceedings, the insurer may also request additional evidence such as FIRs, post-mortem reports, or police investigation documents. The faster and more accurate your documentation, the quicker the claim moves forward.
4. Internal Processing Efficiency: While ICICI Prudential has a robust digital infrastructure for claim processing, certain offline or rural claims may take longer due to slower communication or manual verification steps. In cases involving third-party agents or hospital intermediaries, delays may also occur due to back-and-forth coordination. That said, ICICI Prudential has a strong record of settling claims efficiently when the process is followed correctly and the documents are in order.

Why Choose ICICI Prudential for Life Insurance?

ICICI Prudential stands out as a reliable life insurance provider thanks to its impressive claim performance. It boasts a strong claim settlement ratio of 97.52%, ensuring that the vast majority of claims are honoured. Not just that, its amount settlement ratio is a healthy 95.1%, indicating that high-value claims are also paid out reliably. Additionally, 94.27% of claims are settled within 30 days, showcasing its commitment to swift processing. What further sets ICICI Prudential apart is its consistently declining complaint volume, reflecting improved customer service and smoother claim experiences over the years.

Why Your ICICI Prudential Life Insurance Claim May Get Rejected?

When it comes to life insurance, claim rejections usually stem from discrepancies in the information provided or violations of policy terms. While ICICI Prudential has a solid track record for claim settlement, here are some common reasons a claim might still be denied — and how you can avoid them:

1. Non-Disclosure: One of the most common grounds for rejection is hiding or failing to disclose your medical history. When applying for a term plan, you’re required to mention any pre-existing illnesses, such as diabetes, asthma, heart conditions, cancer, or autoimmune diseases. Even if the omission was unintentional, ICICI Prudential may consider it a breach of good faith. Since your health details directly affect the underwriting and premium, any gaps in disclosure can lead to the claim being declined during assessment.
2. Death Due to Smoking/Drinking/Substance Abuse: If the policyholder’s death is caused by excessive alcohol consumption, smoking-related complications, or illegal drug use — and these habits were not disclosed at the time of policy purchase — the claim may be rejected. However, if such habits were declared upfront, the insurer typically honours the claim. Like most life insurers, ICICI Prudential includes specific exclusions related to substance use, especially when there’s a case of nondisclosure or misrepresentation.
3. Death During Unlawful Acts: Life insurance doesn't cover deaths that occur while engaging in criminal or illegal activities. This includes scenarios like participating in robberies, riots, terrorist acts, or even resisting arrest. For instance, if someone dies during an escape from law enforcement, ICICI Prudential is legally allowed to reject the claim based on breach of policy terms.
4. Suicide Within the First Year: As per standard industry practice, ICICI Prudential includes a suicide clause in its term policies. If the policyholder dies by suicide within one year of purchasing or reviving the policy, the insurer is not liable to pay the full sum assured. In such cases, only a portion of the premiums paid may be refunded, depending on the policy’s terms. After one year, however, suicide is treated like any other cause of death and processed typically.
5. Fraud or Misrepresentation: Falsifying information — whether it’s about age, income, health status, or lifestyle habits — is a surefire way to get a claim rejected. For example:
   1. Declaring a lower age to reduce premiums
   2. Hiding treatments or surgeries from the past
   3. Forging documents such as income proofs to qualify for a higher cover.
      
      ICICI Prudential conducts stringent checks, especially during the claim stage. The insurer can deny the claim if any such fraud is detected.
6. Incomplete Documentation at the Time of Claim: Sometimes, the claim is valid, but delays or rejections happen because of missing or incorrect documents. These could include:
   1. Death certificate
   2. Identity proof
   3. Hospital discharge summary
   4. Post-mortem report (if applicable)
   5. FIR (in case of accidental or unnatural death)
      
      To ensure smooth processing, ensure all required paperwork is submitted promptly and accurately, ideally with the help of ICICI Prudential’s claims support team.
7. Moratorium Period: As per Section 45 of the Insurance Act, insurers can contest a life insurance policy within three years from the date of issuance or revival. This period — called the moratorium period — gives the insurer the right to investigate and question the policy if there is evidence of fraud, misrepresentation, or suppression of material facts.Once this 3-year window passes, the policy becomes more secure, and claims can only be contested in rare cases involving proven fraud.

Tips to Avoid Claim Rejection:

• Always disclose your complete health history and lifestyle habits honestly at the time of purchase.
• Update the insurer if there are any significant health or lifestyle changes later on.
• Ensure the nominee knows about the policy, where it’s stored, and what documents are needed during a claim.
• In case of death, file the claim with complete supporting documents as early as possible.

How to Track Your ICICI Prudential Life Insurance Claim Status

You can use this link to track your claim status with ICICI Prudential: https://buy.iciciprulife.com/buy/psClaimStatus.htm?execution=e3s1

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Conclusion

While ICICI Prudential may not top the charts in claim settlement rankings, its performance—especially in 2023-24—shows a strong comeback with a 99.2% CSR. The insurer offers a transparent, multi-channel claim process and has consistently improved claim efficiency and customer service. So if you're considering ICICI Prudential for your life insurance needs, their recent performance and strong operational track record suggest you're in reliable hands. Just remember—always disclose all necessary information truthfully and keep your documentation to avoid claim hiccups later.

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Article Disclaimer

The details provided here are for informational purposes only. Please refer to the official website of ICICI Prudential or consult an insurance expert before making any financial decisions. We do not promote or endorse any specific insurer or insurance product.