[Resolved]  Icici Lombard — Nefarious Snakes - ICICI Lombard

Address:	400064
Website:	www.icicilombard.com

I am fed up with following with ICICI Lombard who have cheated me and my family even after paying premiums on yearly basis for health policies.
I had purchased a policy for my mother starting from year 2010, Health Advantage plan – Policy number – 4063i/HAP/05520098/00/000 of which sum insured was Rs 300000 in which I had clearly mentioned that she was suffering from diabetes.

I kept on renewing the policy every year, in the year 2015 while the renewing the policy (Policy # for[protected]i/HPR/93876117/01/000) they offered me a top up policy (Policy # 4113i/XOL/66957123/02/000) of additional sum insured of 500000 based on the base policy which I had with them from 2010. The top up policy was sold on the basis of my base policy.

Now in the year 2016 in the month April my mother was diagnosed with Neuro-Endocrine Tumor Lung + Liver for which she was advised surgery Pulmonary Lobectomy + mediastinal LND.For which we decided to operate in the month of May on the 6th 2016 in Jaslok Hospital under Doctor R.K. Deshpande, for which I filed for pre-approval on the same and received the sanctioned amount of Rs 364000 on the base policy 4128i/HPR/93876117/01/000. When the patient was in the hospital post-surgery, and I submitted the running bill, I was notified by ICICI Lombard that the sum insured against the base policy has been exhausted, so I submitted my top policy 4113i/XOL/66957123/02/000 for the additional sum insured of Rs 500000.

Now here is where the sadistic and nefarious behavior of the insurance company came in play.

They denied my additional claim saying that I had not declared that she was a diabetic in the top up policy. The top up policy (4113i/XOL/66957123/02/000) was sold to me on the basis of the base policy (4128i/HPR/93876117/01/000) and included all the declaration for the same. I don’t understand how you can deny the claim as the hospital and the doctor and even the admission of the patient remains the same. It is not as if we have moved the patient and claiming for some other disease, even if we were they are obliged to honor the top up policy as it was sold exclusively based on the existing base policy. Even after repeated calls and emails to the customer care guys who clearly have no idea what is politeness and being humble is, they still state that it is my fault that I did not declare that she is a diabetic in the top up policy.
After 5 days of constant mental harassment and no sleep, also I needed to take care of my mother, I decided to take her home after paying the additional bill of Rs 189000.
I came home and started to take care of her, it has been 3 months now and she is recovering well.
I am now of sound mind and body, hence am writing this complaint on your forum as a last resort for some miracle to happen, if they do not respond clearly, I plan on pursing the matter legally, so that such cases do not happen with other commoners in the near future.