[Resolved]  National Insurance Company — Non compliance of terms and conditions of Insurance

Address:

Delhi

1. Name of the complainant: Vinod Kumar Kapur
2. Address of the complainant: 314 Pragati Apartments
Punjabi Bagh Club Road,
Paschim Vihar,
New Delhi-110063

3.E-mail/Telephone/Fax : [protected]@gmail.com Mob[protected]Tel [protected]
: 
5. Name of the Insurance company: National Insurance Company
6. Address of the servicing office/branch with office code(if available):
The National Insurance Company
Hardhian Singh Road
Karol Bagh
New Delhi-100005
7. Policy number/Proposal deposit number: 1360501/48/10/[protected]
Dated 24.07.2010
Due date 23.07.2011
8. Nature of complaint: Non-life
Policy related Policy related Health Insurance -Baroda Health Insurance
Non Fulfillment of terms and conditions of policy

10. Details of complaint :
I am holder of Policy No360501/48/10/[protected] dated 02.07.2010 effective date of insurance is 24.07.2010.The policy was renewed before due date .The policy is being renewed regularly for the last 3 years without break and this is 4th year of my insurance and no claim has ever been lodged.
The details of previous health insurance policies are as under.
Policy No Dated Due date Amount
360501/48/09/[protected] 24.07.2009 23.07.2010 5,00,000
360501/48/08/[protected] 24.07.2008 23.07.2009 5,00,000
360501/48/07/85000/1079 24.07.2007 23.07.2008 5,00,000

Since it is 4th year of insurance I am entitled for the following as per terms of insurance policy:
1. Free health Checkup up to 1% of insured amount i.e. 1% of Rs 500000.00 or say
5000.00.
2. All pre existing diseases are to be covered.

Issues of Dispute
I had requested insurance company for the following:
1.To issue letter to any hospital or pathological laboratory approved by insurance company or TPA for my medical checkup .
2. To issue endorsement that all preexisting diseases are now covered

In spite of my mails, reminders and telephone calls the insurance company is not responding.
I request you to please advise the insurance company to do the needful at the earliest.
A copy of my letter sent to insurance company is attached.

Vinod kumar Kapur






Vinod kumar Kapur
314 Pragati Apartments
Punjabi Bagh Club Road,
Paschim Vihar,
New Delhi-110063
10.10.2010

The Branch Head,
The National Insurance Company
Hardhian Singh Road
Karol Bagh
New Delhi-100005

Dear Sir,

Re: Baroda Health Policy

I am Baroda Health Policy holder for the last 4 years as detailed below:

Policy No Date Due on
1360501/48/10/[protected] 24.07.2010 23.07.2011
2360501/48/09/[protected] 24.07.2009 23.07.2010
3360501/48/08/[protected] 24.07.2008 23.07.2009
4360501/48/07/[protected] 24.07.2007 23.07.2008

After completion of 36 month of continuous coverage I am entitled to following
A. Benefit of preexisting diseases if any.

B. Health Checkup

1. Please arrange to issue a rectification that the benefit as mentioned in A. above is available to me.

2. Please arrange to send me the details for free health checkup.

3. Till date I have not received the ID Cards from the TPA. Please arrange to get the same issued at the earliest

Yours faithfully,

Vinod Kumar Kapur