[Resolved]  ICICI Lombard Medical Insurance — non settlement of my medical claim

I was insured for the ICICI Lombard health care scheme which is valid up to 24th feb 2009 . ( policy no : 4034/fpp/03294458/00/000, Card no: IHPN[protected]/01)

During the insured period I fell down at the toilet and was admitted to a hospital listed in your handbook ( MIMS – calicut). At the time of insuring I was told that this is cashless treatment option and no need to pay any cash upto 3 lkhs. Also the executive told that I will be paid Rs.1000/- per day at hospital ( ref. the tele conversation recorded at your office )! But at the hospital they didn’t allowed for cashless treatment!

I paid all my hospital bills from my pocket and I sent the bills to your claims settlement department – TTK ! The total claim amount was only Rs.5057.00 + 1000x2 for 2 days at hospital (which was told, will credit to my icici account) . My hospitalization was a genuine case and I submitted all documents as instructed but still I was only paid Rs. 2607/- initially. Again I communicated with TTK health care and then they settled Rs.2165/- as second part ! still I lost Rs.285/- + agreed 1000/- for 2 days ie Rs.2000/-

The reasons informed me for not allowing Rs.285/- was that hospital registration charges are not payable and No lab reports for some amounts ! as you know normally a patient will pay registration charges in hospital only when he /she is admitted there to take treatment and not for attending any party or star show at hospital !!! Also the full lab report was submitted from my side which I am ready to prove at any extend!! ( refer the copies of letters & documents of earlier correspondence with Ttk , attached here with for your kind reference)

My total loss in this case was Rs.2285/- I have approached TTK directly for settlement without the help of any agents! I think that is the reason for loosing money for me !!! Bcos I can see people getting claim amounts without any issues if submitted with the help of insurance agents!

So now please let me Know that , if you were at my place, will you renew your ICICI Lombard policy further to one more year? Will you recommend this company to your friends ?
i can prove all above said information with solid supporting docs

sheen, [protected]