Apollo Munich Health Insurance — Optima Restore

Address:

New Delhi, Delhi

I, Rohan Sharma having an insurance policy “Optima Restore” with Apollo Munich Health Insurance, policy no: 110103/11121/AA00434364.
In September 2016 I had filed a claim with the AMHI which got rejected last week under INCORRECT reasons. My claim id is 446608.

On 26th Aug 2016 my wife got admitted to Apollo Munich’s network hospital “BLK Super Speciality Hospital” for one night. Post discharge from the hospital I contacted AMHI customer care, briefed my case and as per your policy I have sent all the required medical documents (Blood test reports, doctor’s prescription, discharge summary etc.) along with the claim form for the reimbursement.

After few days claim team again asked for additional documents (hospital’s detailed bills, doctor’s certificates on various queries raised by claim team). Their requirements/queries kept coming till first week of November and I was responding to the best of my knowledge and with the consent of the treating doctor.
Now after so many follow ups claim team said they can’t pass my claim and have rejected under wrong/unreasonable reasons and they are trying to correlate my wife’s illness with those ailments which don’t cover in the first year of the policy. Moreover, as per policy agent there are only 5-6 diseases which don’t cover but rest do cover from the very next day of the start of the policy.
With these kinds of fake responses I am seriously very upset and really regret that how I took such an important policy from so unprofessional company.

I request you to pls revisit my case or arrange a call back so that I should be given a chance to clarify the case history. Hence I should be awarded with honest and appropriate solution.