[Resolved]  Bajaj Allianz General Insurance / Health Insurance — Rejecting Medical Claims

Address:

Pune, Maharashtra

My name is G S Sridhar. I have a health policy with Bajaj Allianz General Insurance.
The policy name is STAR-PACKAGE, Policy No. OG[protected]-00000270.

On 24-March-2010 around 3.00AM I got a mild chest pain and rushed to Medipoint Hospitals Pvt Ltd, New D.P. Road, Aundh, Pune. I got addmitted to into ICU as there were variations in my ECG.

On 25-March-2010 I got shifted to Ruby Hall Clinic, Pune to do a Coronary Angiography and I had been admitted in Ruby Hall Clinic from 25-March-2010 to
26-March-2010.

As soon as I admitted in to Ruby Hall clinic we have informed Bajaj Allianz customer care.

On 25-March-2010 (I got discharged on this day), I got a fax from Bajaj Allianz stated that my claim was rejected due to pre-existing diseases as I am a diabetic (this is the standard reason from Bajaj Allianz for the rejection of claim). The chest pain was not because of my diabetes.

I had spend around Rs.23000 (including hospital charges and medicines) and I did not get a single paise from the insurance company.

I could not understand what's the use of medical insurance when they are rejecting claim.

In the policy instructions, under EXCLUSION SPECIFIC to HOSPITAL CASH/ HEALTH GUARD/ CRITICAL ILLNESS they have listed almost all diseases that affects the human being :)

I therefore submitting this complaint before the Consumer Forum for necessary intervention in getting my claim.

My contact No.[protected]