Icici Lombard — Reimbursement of Hospitalization claim for the year 2021-22.

Jul 14, 2022

Updated by AKBage Dear sir, it is to bring your kind notice that my claim is rejected due to the same cause they mentioned earlier. I got a call from the ICICI Lombard representative on the 07th of July 2022, and I clearly mentioned my hospitalization cause and renewal of my policy. It is simply a matter of their irresponsibility towards their client. It is a true statement as a matter of fact I furnished below:
1. I buy this policy on 20th Feb 2020. On the 10th of August 2020, I was hospitalized due to my health issues andwas diagnosed with Organic Manic disorder, Chronic Anemia, and Hypothyroidism. At that time claim was raised by me but was denied due to the exclusions of policy rules.
2. Since then I am under observation and continue medication for the abovementioned health issues. I took Iron tables since I was diagnosed and my Hb level did not rise during 2 years of medication. So I was suggested by doctors for further examination for Chronic Anaemia.
3. Before 19th Feb 2021, I renewed my policy for the next period of 2021-22 and the ICICI representative Mr. Barun Saha told me that the renewed policy now covered all the enlisted standard diseases (the list was sent through the mail which is the base of this complaint) which were not covered at the time of newly purchased policy as I am their loyal customer. During the period of renewal policy, it is clearly said that if any of the enlisted disease(s), if diagnosed during hospitalization the claim, will be refunded. It was clearly said that if I was hospitalized for any reason and if I was diagnosed positive for enlisted standard disease(s) the claim will be refunded.
4. On the 04th of Feb 2022 before expiry of the policy I was hospitalized for further examination of Chronic Anemia, I was diagnosed with Chronic Anemia- Microcytic Hypochromic Anemia, Hypothyroidism, Organic Mania along with Gastric Erosions- Ulcer in Z-line, Hiatus Hernia, H-Pylori Positive. The later diseases are covered in my renewed policy for which I raised the Hospitalization claim of Rs, 27074/- only.
5. Now, when I was made a query for the reason of rejection, the ICICI Lombard representative said that there is no such medical record found in the hospital when the company representative visited the hospital for case investigation, which is a fully fake statement because till date I am visiting the hospital for the same reason as suggested and all medical records are up to date in their server.
6. Lastly, I want to mention that the reason, they are giving for rejection is totally unfair. This is what I feel as a policyholder.
It is my sincere request to you, kindly take serious action in this matter, as it is too hard to bear this financial loss to me. With lots of faith, I am looking forward to your action. Thanking you.