Cholamandalam Ms General Insurance Co. Ltd — Denial of Chola MS Health Reimbursement COVID-19 Claim No. [protected]

Address:

MUMBAI Branch

References:1) CHOLA Membership No. A6326676A - RAJESH MISHRA
2) Certificate No. : 2876/00032543/00000/000/02
3) Chola MS Claim No. [protected]

Respected Sir/Madam,

I beg to state that I have been denied my COVID-19 claim of Rs. 1, 00, 047.00 by CHOLA MS Health Insurance (Copy Enclosed) for which I have been a member for the last four years. The expenditures includes medicines, HR-CT Chest Scan, RT-PCR Test, Pathology tests, equipment, Ambulance, every day doctor" & Nursing charges etc. as per doctor's advise and its prescriptions. The denial has been on account of :

"On perusal of the claim documents, it is observed that the member got admitted in the hospital for the treatment of Covid -19 and enclosed documents suggest all member vitals are stable and as per MOHFW guidelines member does not require hospitalization and treatment can be done under Home quarantine".

Sir, I have been a member of the Chola MS Health Insurance policy for the last four years and never claimed any amount since then.

Sir, I lost my job in COVID and am still struggling to find a source of income to run my family.

During the second wave of COVID April- May 2021, I became infected & a victim of COVID disease and incurred heavy expenses for my treatment under the Medanta Hospital run COVID center at Gurgaon.

It is to be noted that I have taken the Chola MS Health Policy for my health not for keeping this policy in the file. When there is a threat to my Health, this policy should work for me.

Sir, as you are aware that almost all the hospitals and medical establishments did not have places to treat COVID patients. The patients were treated underneath the trees, on the roads, on the trucks, isolation centers & vehicles wherever they found convenient. The situation remained the same for me in the above case. Hence, I was given Medanta run COVID center as vacancy bar was prevailing due to emergency & critical patients in the hospital in April-May 2021(Second Wave of Covid).

Sir, I request your intervention to conclude my policy claim positively under my grim financial conditions, I am going through.

Thanks & regards,

Yours sincerely,

Rajesh Mishra