Aditya Birla Health Insurance Complaints & Reviews

R / SIR
I.am der Ashok Lakhabhai My policy number is[protected]. My health policy for the second year. Renewed from 27/09/210. And: Ta. I received an appointment from the company for the Annual Health Checkup (CAT32) on 01/10/21 at 9/00 AM on 5/10/21. After visiting Sangani Hospital Madhusudhan Nagar Keshod, Gujarat pincode 362220 with my family at the laboratory Our urine and blood tests were done and then we went to the first floor for cardiogram and physical test. There was no ladies staff present in the cardiogram room for cardio test and physical test of ladies. I asked if there is no ladies staff for physical test and cardiogram test of ladies. The answer is no and stated that the ladies no cardiogram test and physical test will be done by the male staff and my wife's physical and cardiogram test done by the male staff during this cardiogram test, I felt that no privacy of the woman was maintained. Incoming and outgoing in this room and other male staff sitting down in this room: which is a really serious matter. It seems necessary to take appropriate action at your level. If no action is taken from here, I will consider the matter further
Corona's guidelines were not followed during this test
I have photographs of evidence in this regard

Dear Gaurav Tripathi,

Policy Number: [protected]
Policy Holder: Chetan Zope
Cliam Number: [protected]
Patient Name: Mrs Nilima Vilas

Team please contact your panel doctor which is investigate the patient at the time of policy opening, we clearly mention no any earlier diseases to the patient.

I wish to inform you that the i had taken up activ assure - diamond policy for sum of Rs.300000 in the year[protected]. While taking the policy as a mandatory requirement as insisted by aditya birla, i have under gone all medical tests on concall due to Covide-19 as per aditya birla told us as per requirement of aditya birla before policy issue with your recognized panel of doctors during their check-up all the parameters were fine.

When i had a admited in hospital for my further course of treatment i had undergone further course treatment at Shree Datta hospital (Jalgaon Maharashtra India) I had given my request for reimbursement claim as per treatment as per the provision available in the policy. However, from long time from April-2021 to Sep-2021 i am shocked to receive your message as follows.

""On scrutiny of the documents it has been observed that On scrutiny of the documents it has been observed that the patient was admitted for treatment of Covid 19. However, the patient has a history of Hypertension since 2 years, which was not disclosed in the proposal form. and hence we are unable to approve the claim.""

Since rejection of my claim is base-less i had again resubmitted all original bills along with documents through insurance form part a & b as per insurance provision. My reference number for the claim as per above mention the same has also been rejected due to the following reason

On scrutiny of the documents it has been observed that the patient was admitted for treatment of Covid 19. However, the patient has a history of Hypertension since 2 years, which was not disclosed in the proposal form.

Since i am not accepting the reason for rejection, i had taken up with the grievance cell about my rejection. Since the grievance cell has also rejected my claim without any valid remarks, i further escalating the same as per the provision of insurance

Dear Sir,

I Have Claim in Adithya Birla Health Insurance in May-2021,
Policy No. :[protected],
Claim No :[protected],

Policy Holder is Dineshbhai Bhalala & Claim Person is Pushpaben Bhalala,
Dineshbhai was dead due to Covid-19, so Cheque was submitted by name of pushpaben (Nominee of Policy).
Till on date after Submitting all Document Claim was under process,

Request you to do needful for resolving matter.

I submitted claim on April 19th, from then Aditya harrassed me with this doc that doc, inspite of submitting everything that needed, they fail to reimburse the amount that's due for customer. They don't stand by their rule of clearing the amount in 30 odd days it's been close to 100 odd days and no one knows what's going on why there's a delay etc.

So much deduction in covid-19 claim

I have provided all the document in correct format. I have all communication and mail acknowledgement from them. But still they are hanging me since 19 may 2021 and it is 01 jun 2021 today. They are just keep it waiting unless and until I call them regarding this. Every time they make and ticket and delayed my claim by 5 days after every ticket. I suffered a lot.

I have cancelled policy with Aditya birla on 26 April and now its been more than 60 days and i have not received any refund from them.
i have called/emailed them several times but they always ask for more time. it seems that they are FRAUD.

Policy number[protected]

I am still looking for Refund

I have shared a mail on 9 th may which they ask me to share documents after a 10 days, again they are saying its a wrong mail send me to another mail id .
But again i shared a documents to mail id which is shared from they end but still no response only i am getting a reply wait for 48 hours after 48 hours again 48 hours . but as per mail its as to be process within 30 days.

I am here to raise a complaint that claim should be process as soon as possible and keep me updated on my claim - certificate number : GHI-HD[protected]

This is in referwnce to my cancellation request of my policy which i took recently of aditya birla health insurance company as i am not satisfied with their services and loading premium charges so i had given proposal cancellation requestion 4 times till now but till now my policy is been cancelled and i am through lot of harrassment by their customer services who never reply properly to my given request.
Below i am mentioning my camcellation request number which i given to them and also proposal details i need your help and a strict action to be taken against this company for denying customer request.
Details:
Company Name :Aditya birla health insuance
Proposal number: [protected]
Request given: cancellation of proposal

Requeste date:22/04/2021

Hi, reference no. for your query is CAS[protected]P3M7Q7. Our Executive will connect with your shortly. Regards, Aditya Birla Health Insurance

Request date:29/04/2021

Hi, reference no. for your query is CAS[protected]P0D0D9. Our Executive will connect with your shortly. Regards, Aditya Birla Health Insurance

Request date :30/04/2021
reference no. for your query is CAS[protected]T0L5Y4. Our Executive will connect with your shortly. Regards, Aditya Birla Health Insurance

Request date: 10/05/2021
Hi, reference no. for your query is CAS[protected]W7Q9F2. Our Executive will connect with your shortly. Regards, Aditya Birla Health Insurance

Please look into this matter and help me to cancel my proposal at the earliest and also take strict action against this company.

Aditya Birla health did not provide updates/ no action on my claim submitted/ its been long time(i.e.5 months) since I submitted the claim and frustrating for insurer with no help from Aditya Birla Health also, following up so many times but still no proper response from Aditya Birla Health. Please do the needful.

Claim #:[protected]
Claim #:[protected]

Policy Number- GHI[protected]

My claim was submitted and that was rejected after 2-3 months with a wrong reason and I have provided all the documents as they have asked everytime. 80+ days over now they are saying it will go under the rejection. In between I have taken regularly status and they send 2 times investigation one of at the time of hospitalization and another one after 1 month both the investigator was satisfied with the documents and all that..

महोदय,
मी राकेश राविन्व्द्र देशमुख aditya birla health insurance कंपनी चा policy धारक गेल्या ३ वर्षापासून आहे तरी मी
january २०२१ मध्ये त्रिमूर्ती हॉस्पिटल अंबरनाथ येथे admit झालो होतो तरी admit होताना मी आपल्या कंपनी ला फोन द्वारे सूचित
केले होते कि मी admit होत आहे तरी मला असे साग्न्यात आले कि तुम्ही हॉस्पिटल मधून discharge घेतल्या नंतर आम्हाला
कळविणे, त्याअनुषंगाने मी २२/१/२०२१ ला mail द्वारे company सर्व document च्या प्रती पाठवल्या व त्याच बरोबर रोज पाठपुरवठा
हि करत होतो तरी company कडून document प्राप्त झाले नाही असे दिनांक ८/०२/२०२१ रोजी मला साग्न्यात आले ( तेही जेव्हा मी
customer care ला फोने केले तेव्हा ) तरी माझी प्रकृती ठीक नसताना हि मी स्वत ४० किलोमेतर एकतर्फी दुचाकी वर प्रवास करून
आपल्या ठाणे येथील कार्यालयात सर्व original
documents सुब्मित केले .काही दिवसांनी आपले प्रतिनिधी माजी भेट घेवून गेले
तरी नंतर आपणास लगातार mail द्वारे संपर्क साधल्यास शंकेचे निरसन केले गेले नाही दिनांक १६/३/२०२१ रोजी जेव्हा मी आपणास
customer care वर फोने केले तेव्हा मला सांगण्यात आले कि आपले claim रेजेच्त करण्यात आले आहे, त्या संदर्भात मला कोणते हि
पत्र देण्यात आले नाही, सदर बाबीची विचारणा केल्या नंतर दिनांक १२/०३/२०२१ ला mail द्वारे कळविण्यात आले व कारण महोदय,
मी राकेश राविन्व्द्र देशमुख आपल्या कंपनी चा policy धारक गेल्या ३ वर्षापासून आहे तरी मी जनुअर्य २०२१ मध्ये त्रिमूर्ती हॉस्पिटल
अंबरनाथ येथे admit झालो होतो तरी admit होताना मी आपल्या कंपनी ला फोन द्वारे सूचित केले होते कि मी admit होत आहे तरी
मला असे साग्न्यात आले कि तुम्ही हॉस्पिटल मधून discharge घेतल्या नंतर आम्हाला कळविणे, त्याअनुषंगाने मी २२/१/२०२१ ला
mail द्वारे आपणास सर्व document च्या प्रती पाठवल्या व त्याच बरोबर रोज पाठपुरवठा हि करत होतो तरी आपल्या कडून document
प्राप्त झाले नाही असे दिनांक ८/०२/२०२१ रोजी मला साग्न्यात आले ( तेही जेव्हा मी customer care ला फोने केले तेव्हा ) तरी
माझी प्रकृती ठीक नसताना हि मी स्वत ४० किलोमेतर एकतर्फी दुचाकी वर प्रवास करून आपल्या ठाणे येथील कार्यालयात सर्व original
documents सुब्मित केले .काही दिवसांनी आपले प्रतिनिधी माजी भेट घेवून गेले
तरी नंतर आपणास लगातार mail द्वारे संपर्क साधल्यास शंकेचे निरसन केले गेले नाही दिनांक १६/३/२०२१ रोजी जेव्हा मी आपणास
customer care वर फोने केले तेव्हा मला सांगण्यात आले कि आपले claim रेजेच्त करण्यात आले आहे, त्या संदर्भात मला कोणते हि
पत्र देण्यात आले नाही, सदर बाबीची विचारणा केल्या नंतर दिनांक १२/०३/२०२१ ला mail द्वारे कळविण्यात आले व कारण
discreapancies and lapses noted in event of hospitalisation असे कळविण्यात आले सदर claim बद्दल कुठलीही
querry raise न करता माझा claim reject करण्यात आला .
तरी दिनांक १६/०३/२१ रोजी मी हॉस्पिटल मधील डॉक्टर यांना भेटून अजून साम्भांडीत दस्तावेज व reconsideration साठी पत्र घेवून
आपल्या ला mail केले तरी your case is under process हेच status आज पर्यंत आहे .
तरी आपल्या online portal वर ह्या पूर्वी माज्या claim सम्बन्धित स्तिथी मी पाहू शकत होतो परंतु आजच्या घडीला portal वरून
सर्व माहिती erase झाली आहे व policy lapsed असे दाखविण्यात येते ज्याने करून मला माज्या claim ची स्तिथी काय आहे कळून
येत नाही.
तरी महोदय अशा panademic घडीला आम्ही सामान्य माणसे आपल्या सारख्या प्रठीस्तीत कंपनी वर अवलंबून असतो कि काही कमी
जास्त झाले तर heatlh insurance आहे, तरी आपण माझा रेकॉर्ड check कराल तर आपल्या निर्दशनास येईल कि मी आपल्या कडील
तीन वर्षाच्या policy काळात आजपर्यंत ह्या व्यतिरिक्त कुत्ल्याही परकारचे कुत्ल्याही कंपनी मध्ये claim केलेला नाही.
तरी आपणास विनंती आहे कि लवकरात लवकर claim settelment करावी त्यासाठी लागणारे पूर्ण सहकार्य मी करण्यास तयार आहे,
(आताही माझी प्रकृती ठीक नाही परंतु जर का आपण सांगत असाल तर मला पुन्हा एकदा नाईलाजास्तव आपल्या ठाणे इथील
कार्यालयात जो माज्या पासून एकतर्फी ४० किलोमेतर च्या आसपास आहे यावे लागेल तरी मला डॉक्टर यांनी bed rest चा सल्ला
दिला आहे परंतु मजबुरी खर्तीर जीवनाशी रीस्क घेवून यावे लागेल
noted in event of hospitalisation असे कळविण्यात आले सदर claim बद्दल कुठलीही querry raise न करता माझा
claim reject करण्यात आला .
तरी दिनांक १६/०३/२१ रोजी मी हॉस्पिटल मधील डॉक्टर यांना भेटून अजून साम्भांडीत दस्तावेज व reconsideration साठी पत्र घेवून
company ला mail केले तरी your case is under process हेच status आज पर्यंत आहे .
तरी company online portal वर ह्या पूर्वी माज्या claim सम्बन्धित स्तिथी मी पाहू शकत होतो परंतु आजच्या घडीला portal
वरून सर्व माहिती erase झाली आहे व policy lapsed असे दाखविण्यात येते ज्याने करून मला माज्या claim ची स्तिथी काय आहे
कळून येत नाही.
तरी महोदय अशा panademic घडीला आम्ही सामान्य माणसे insurance कंपनी वर अवलंबून असतो कि काही कमी जास्त झाले तर
heatlh insurance आहे, तरी आपण माझा रेकॉर्ड check कराल तर आपल्या निर्दशनास येईल कि मी company कडील तीन वर्षाच्या
policy काळात आजपर्यंत ह्या व्यतिरिक्त कुत्ल्याही परकारचे कुत्ल्याही कंपनी मध्ये claim केलेला नाही.
तरी दिनांक ७/४/२०२१ रोजी company कडून काही सूचना न मिळाल्या कारणाने मी customer care ला फोने केले तर मला सांगण्यात
आले कि case reopen करता येणार नाही व मी कारण विचारल्यास सदर बाब गोपनीय आहे व आम्ही सांगू शकत नाही असे सांगण्यात
आले .ह्या वेळी सुद्धा मला कुठल्याही प्रकारचे पत्र company ने दिले नाही .
तरी महोदय discreapancies and lapses च्या नावाखाली company माझे claim कुठलेही ठोस कारण नसताना reject करत आहे
व मनमानी कारभार करत आहे तरी आपण मला न्याय मिळवून द्यावा हि नम्र विनंती

राकेश रवींद्र देशमुख
claim number[protected]
policy certificate number GHI-BF-19 IN 4329306
member id GHI[protected]
registered number [protected]

My claim was submitted and that was rejected without any reason and without looking at document submitted by TPA..

It looks like the person who rejected claim was only trying to save money for the company by unduly rejecting prior approval

We have tried to contact ur team through help desk and through tpa but no response.

This is a pathetic services and will never recommend to anyone...

U can save money for the company by such behavior and undue rejection and non responsiveness..

Humari taraf se kumarmanglam birla ke janamdin par gift de dena iss claim ke paisa se as he may need money that's why his company is behaving like this and after losing money in idea he may be looking for some money to spend on his birthday

Regards

I have provided all the documents as they have asked.
claim id :[protected]

reasons they gave for rejection:On scrutiny of the documents it has been observed that the patient was admitted for treatment of Hemodynamically stable Ventricular Tachycardia. However, the patient has a history of On & off Palpitations since a year this pre-existing disease and was not disclosed to us in the proposal form and hence we are unable to approve the claim.

In the mri report:it is showing clear report of Heart with no issue.
On the admission to the Hospital, the Doctor guessed Tachycardia, but after the MRI report they concluded for EP treatment of Heart.
EP is not a pre-existing type, it happens all of a sudden.
I have also shared the doctor note regarding, this case is not pre-existing type.

I will attaching the mail of Aditya birla insurance team,
MRI report -- stating the Heart is good, Doctor note -- it is emergency case, Doctor prescriptions -- concluding for EP treatment, Head of Customer Service--Mail escalation team of aditya birla -- if we drop a mail also ..unable receive a mail or address couldn't be found

Please help me out in this.

Claim[protected]
80+ days over now they are saying it will go under the rejection. In between I have taken regularly fallow up with them but they regularly saying it's a under process . The tat was 45 days.
I think they don't want to pay the money. That's why they are raising issue. Creating new pictures but I have all proofs with CCTV footage . I will case in court against poor Aditya Birla Helath insurance

My Name is Rakesh Yagneshwar, I have purchased a Policy from the policy bazaar, when I lost my job due to Covid pandemic situation. I got admitted and used their cashless facility, and came to know at the end am paying 40000/-, against the bill of 134000/- and my sm assured was Rs. 500000/- + top-up of 150% if sm assured is used. Even i opted for twin occupancy and BMC supported ward in Sanjeevani Hospital In Malad East. They have charged me almost 340000/- for the PPE kit. And Aditya Birla Said it's covered up to some extent. Bt nothing is done after a complaint at their portal so many times. they have very less CRE to answer the call when we need support. almost they will not answer your call when it comes to a grievance. I advise you do not to purchase their plan. Even they are denying my wife's claim which is approved by govt in new gidelines.

We have corona decease before 20sep and I already claim registered to Birla health insurance co and all claim related process under go but still time i haven't received claim amount total Rs. 75000.

at this time I intimated claim

claim no name claim amount
[protected] priyaben atulbhai mehta 25000
[protected] priyanshu atulbhai mehta 25000
[protected] mehta atul dineshchandra 25000

also claim was reputed

So, my humble requesting to you pls settle claim amount

I submitted the documents for reimbursement and I have drop the email for update the status so I get the idea when will be settled but I didn't received any update email regarding the status of claim 2 week I am calling to customer care and they said they are working on it. But I am not sure they are looking into the fils .I don't think the claim team are working in it. 30 days over and still claim status not received. Why ?

My father Mr. S B Bellary was admitted in Prakriya hospital and got discharged on 14th October 2020. Again the discharge process was not at all seamless because of very bad customer service of Aditya Birla health insurance, anyways he got discharged at around 9:18 pm.

1. Received approval letter at around 9:18 pm on 14th October 2020. According to that co pay was zero.

2. Within a few minutes at around 9:24 pm on 14th October 2020 received one more approval letter. According to that approved amount was Rs.127216.00, Amount to be paid by insured Rs. 22236.00

3. Your representative called me at around 9:40 pm on 14th October 2020 and said, there is a mistake in the approval letter. According to my insurance plan I need not pay any amount to the hospital and Aditya Birla health insurance will approve the full amount which is Rs. 166890.00. Since it was already late your representative asked me to get my father discharged and Aditya Birla will coordinate with the hospital and promised me they'll send new approval, according to which I need not pay anything, which means Aditya Birla health insurance will approve the full amount of Rs. 166890.00.

4. On 15th October 2020 11:21 am, I received whats app communication from your representative, according to that communication, new approval sent to hospital, and as an insured I need not pay anything. Full amount is being approved.

5. On 15th October 2020 5:51 pm, hospital also confirmed that they received new approval, according to which as an insured I need not pay anything. Full amount was approved, which is Rs. 166890.00 was approved

6. Received shocking information from the hospital saying Aditya Birla health insurance sent one more new approval on 15th October 2020 8:36 pm. According to that new approved amount was Rs 105574.00, and discount of Rs.29400.00, as an insured I need to pay Rs. 31916.00

7. Raised complaint to Aditya Birla health insurance on complaint and grievance cell on 17 October 2020 2:07 pm, asking for reimbursement of Rs. 31916.00, since you promised me that as an insured I need not pay anything, Aditya Birla health insurance will approve the full amount.

8. But to my disbelief on 23rd October 2020 01:47 am you sent one more approval letter, according to that approved amount was Rs. 127216.00, as an insured I need to pay Rs. 39674.00

Summary:
1. On 14th October 2020 at 9:18 pm, I need to pay Rs. 0
2. On 14th October 2020 at 9:24 pm, I need to pay Rs. 22236.00 (Your representative only called me promised me that this will be waived off, because it is wrong and mistake)
3. On 15th October 2020 at 11:21 am, I need to pay Rs. 0
4. On 15th October 2020 at 8:36 pm, I need to pay Rs. 31916.00
5. On 23rd October 2020 01:47 am, I need to pay Rs. 39674.00

Can you please explain how this works? Day by day you are sending new approval asking me to pay more and more. What is the guarantee that tomorrow you'll not send new approval saying I need to pay Rs. 50, 000 day after tomorrow one more letter saying I need to pay 1 lakh. This is really unbelievable and pathetic.

In my previous complaint I clearly mentioned I need reimbursement, I did not mention I ll pay more. According to conversation and all the documents attached Rs. 31916.00 has to be reimbursed. Instead you are asking me to pay more. How is this justifiable?

Please reimburse Rs. 31916 immediately

Hello sir/mam mera name sonu jha hai mene bajaj Finserv se Aditya Birla health insurance ki 2 policy li thi jiska loan number 401REMFY407026 jiska policy number GHI[protected] hai jo ki bajaj Finserv aur Aditya Birla health insurance ko mene mail karke cancellation ki request ki thi jiska refund 5/5/2020 ko mere bajaj emi network card me add ho gya tha but mene jo dusre loan number 401REMFY407031 jiska policy number hai GHI[protected] cancellation ki request ki thi jo ki Aditya Birla health insurance ki taref se cancel kar diya gya tha but abhi tak iska refund mere bajaj Finserv account me nhe kiya gya hai return my money back

From[protected]

To,
Manager
Aditya Birla Health Insurance

Ref - An amount of Rs 1680/ is debiting monthly to my bank account without my permission or approval Please cancel the insurance policy for the Bajaj Finservices Loan account No- 400REMGA996460 with immediate effect and refund the premium collected so far .

With regards
Avss Subramanyam

Unprecedented debit from my a/c no. [protected] the sum of rs 2590/-regarding health insurance without my permission. I have already mail to care. [protected]@adityabirlacapital.com for cancellation the policy on 03.09.2020 but no reply till date. Please do the needful.

Date: 16.04.2020
From
Mohan raj k
Mob-[protected]
B ii - 708, change quarters, indira nagar,
Kurinjipadi (Tk), neyveli-607801

To
Aditya birla health insurance co limited
Chennai

Sub: my genuine claim rejected by grievance cell regarding non approval of my insurance claim - regarding
Ref: by customer id 49545071 & policy no[protected]
My claim reference number[protected] – reg – mohanraj – rs. 319147.00
Dear sir,
I wish to inform you that the i had taken up activ assure - diamond policy for sum of rs.5, 00, 000 in the year november 2019. While taking the policy as a mandatory requirement as insisted by aditya birla, i have under gone all medical tests as per requirement of aditya birla on 17.11.2019 with your recognised panel of doctors during their check-up all the parameters were fine other than my diabetic condition. My diabetic condition has been disclosed in the policy document and the same has been loaded in my policy statement at page 3 of 7 it is to be noted that 20% extra premium has been loaded for diabetes mellitus
During my regular course of check-up for diabetes, it was found on 30.12.2019 that i need to be take medicines for hyper tension. Once again it is to be noted that at the time of taking the policy, i did not have hyper tension for which i had submitted my medical investigation report conducted by your authorised panel of doctor and medical investigation report dated 17.11.2019 has been submitted and the same has been observed and my policy premium has been calculated on considering my medical reports.
On, 20.02.2020 when i had a fracture initially i had been to neyveli general hospital for first aid and then for my further course of treatment i had undergone further course treatment at vasanth subramanian hospital (India) pvt ltd chennai, at the time of admission i had given my request for cash less treatment as per the provision available in the policy. However, at the time of discharge i am shocked to receive your message as follows.
"on scrutiny of the documents it has been observed that non-disclosure of hypertension and diabetes hence your claim is rejected and hence we are unable to approve the claim"

Since rejection of my claim is base-less i had again resubmitted all original bills along with documents through insurance form part b as per insurance provision. My reference number for the claim is[protected] the same has also been rejected due to the following reason
On scrutiny of the documents it has been observed that non-disclosure of hypertension hence your claim is rejected and hence we are unable to approve the claim"
Since i am not accepting the reason for rejection, i had taken up with the grievance cell about my rejection. Since the grievance cell has also rejected my claim without any valid remarks, i further escalating the same as per the provision of insurance
I want to clarify the following points
1. There are no non disclosures from my side at the time of taking my mediclaim policy. Iwish to clarify that i had submitted a detailed medical investigation report from your recognised panel of doctor (Dr. Jaya singh) vide their medical report dated 17.11.2019 which has indicates about diabetes only during the check-up it has been noted that the hyper tension in normal limits and the medical report has also indicates the same.
2. Based on my medical investigation reports only my policy value has been determined and policy has also mentioned about my diabetes mellitus in my policy statement page 3 of 7 that 20% extra has been loaded for diabetes mellitus.
3. When i am taking my policy i had already submitted my detailed medical investigation report dated 17.11.2019 which has been submitted to your office while taking my policy i further wish to inform you that i had done my medical check-up from your specified doctor of adithya birla only by your panel of doctor (Dr. Jaya singh) has also confirmed that i had been only diabetes mellitus at the time of taking the policy and the same has also been accepted and acknowledged by your office and my premium for my policy has been calculated accordingly on your study of my initial medical report
4. It is to be further noted that as per my medical investigation report submitted at the time of taking policy that there is no other pre-existing illness rather than diabetes.
5 during my course of treatment for diabetes mellitus on 30.12.2019 at dr. M. Sivasankar i had been advised to take medicines for hyper tension also which i want to clarify that it is only subsequent to taking the policy with you hence it cannot be taken as pre-existing illness.
.6. It is with deep regret i would like to record that since my cashless claim and insurance claim which has been submitted by part b was rejected without any valid genuine/legal reasons, i was under compulsion to make the complete payment from my own hard-earned money and presently i am without cash for further course of treatment.

7. I had submitted once again my claims for rs, 3, 19, 147.00 along with following documents
A) duly signed form a (Affixing thumb impression due to fracture)
B) duly signed form b from hospital
C) hospital discharge summary
D) hospital bills for rs.3, 19, 147.00 considering the above facts my insurance claim may please be considered and same be settled at early date.

8. I am also enclosing account statement details & copy of aadhar card for settlement of claim.
9. You are requested to review the same and accord approval on priority and pay the proceeds to my account since it is required for further course of treatment
` thanks & regards
K. Mohanraj

 

List of enclosures which has been submitted through part - b is as under:
A. Copy of insurance policy no.[protected], active assure – diamond dated 22.11.2019.
B. Medical check-up done by dr. Jayasingh m. D, 34923 done by aditya birla
C. Medical check-up report dated 30.12.2019 done by dr. M. Sivasankar m. D. D, m (Nephrology)
D. Thumb impressed form a due to fracture
E. Form b with submitted along with hospital discharge summary
F. Hospital bill for rs.3, 19, 147
G. Account details
H. Copy of aadhar card

On 23rd march i have paid 9, 824 towards health insurance premium but after a call from your doctor i was asked to pay 4000rs extra. Then i informed the agent i don't want insurance and asked for refund of money. I was told that it will take 10 working days to get my refund. After ten days when i contacted them i was told that the refund was done on 30th march. But i didn't receive any such refund money. I time and again mentioned this to them, sent my bank statement as a proof but they are not doing anything.

Dear concern,

This is to highlight one of the fraud and wrong commitment sale of a health insurance policy from aditya birla health insurance policy no. [protected].
Before taking policy i had asked to the person i want to add my new born daughter born on 16th june 2019 they committed that i can add her after taking policy after 91 days. And in the month of sep'19 placed a request to add my daughter in my policy, mail conversation is given below, i have followed all the instructions and provided all the documents to them so that they can add my daughter.
On the basis of telephonic conversation they send me proposal form and asked to fill 1st and 2nd page and send on mail we will add.
But on 5th of fab they denied to add my new born daughter in that policy.

Policy start date 01-aug-2019master policy number[protected]
Certificate of insurance no. ghi-hd[protected]

I would request please suggest the correct process to enroll my daughter in my current policy.

Regards,
Kuldeep mishra
[protected]

I am neha garg policy no.[protected]. I was admitted in max super specialty hospital, shalimar bagh delhi on 3rd august 2019 in emergency and the pre auth form and indoor patient documents and all other relevant documents were submitted multiple times to the the care and pre auth claims id. The customer care representative continuously harassed me that they have not received the documents and mislead me and the hospital tpa to send the documents on one email id or the other. At oe time they admitted the receipt of documents and also gave acknowledgement and on the other hand they contradicted their own statement by saying that they have not received the documents. I was a patient out there and took mediclaim policy for easing my mental pressure but on the contrary your whole team harassed me mentally throughout the day and i was able to take my discharge at 12 at night on 5th august 2019 due to which i faced a great mental trauma and my condition further deteriorated. This is sheer malpractice going on your behalf just to harass the customer by not approving his cashless claim and falsely denying the receipt of documents which were sent to you by the hospital as well as from my own registered email id. This is highly professional misconduct caused to a girl who was a serious patient and instead of helping me out you further aggravated my illness by your harassment and malpractice. I was left with no other option to cancel my cashless claim and pay 25 percent extra to the hospital at 12 in night on 5th august 2019 by requesting one of my relatives who paid 52, 000/- hospital bill. You have not only harassed me but my entire family as my brother who is in bhopal was also continuously talking with you people telling about my condition but you people are so insensitive that that you malafidely kept on asking for the documents already sent to you. This sheer malpractice of yours needs to be curbed at an urgent level.

My name Jigar Nanavati, policy no[protected] and claim no[protected]. Its 6 months now still I haven’t received my claim. Every 10 days your people ask for some other documents, are they mad or ill-literate, they even don’t know when they should ask for the documents in the given time line or so. It an harassment to customer. Have given all the documents in the month on Jan 2019. That time they misplaced my original documents and asked for the same after 20 days of submission. Then again I have submitted. Still they are asking for the documents, what you want to prove that this is a fake claim?? After giving X-ray also you couldn’t prove it. Onetime I got a call that my claim is passed and I will get in a week. But still I haven’t received but asking for the documents. I think so all the seniors are ill literate. Yes there was some mistake in the given letter by me, its human error, but given the confirmation also for the same and every documents which was need from doctor I have provided to you, but still every week some new documents you all required.

Are your company is cheating the customers like this. U get us insured and when the time of the claim process you take so much time that customer gets fed-up. And after 5 months your company people say that better try to claim from other insurance company in which I am insured. Who will pass my claim after 5 months of the incident they even don’t know the rule of the claim process of insurance companies, why the hell they are sitting there and what the hell they are doing their job?? Just to harassed the customers. Sorry to use this type of words but you all forced me to use it.

This time I am very serious about this matter. If I won’t get my claim I will get the police complaint against your company as an harassment to customer.

Will be waiting for your reply.

Thanks and Regards

Jigar Nanavati

Sir my fphl claim i'd no.2244344 dt16/01/19 as it is serious case we had not taken cashless polity of any company
Hospital total bill sent with paid seal of hospital
Still again&again they are asking for the same
Anyhow my appointment with doctor is on 11/03/19 i collect it at that time send you.
We appreciate prompt&quick service from your famous company
My arm no 1779&policy of.[protected] dt01/06/19
Mobile[protected]&all records three times sent to abslmf belgaum&theirmobile[protected]

I want to be cancel my aditya birla health insurance policy bearing no is[protected], regarding this i have already summited cancellation status in hdfc bank as well as aditya birla health insurance company but still they didn't take any instiative regarding this. My name is alok priyadarshi i'm hdfc bank regalia first credit card holder through this card hdfc customer care gave me aditya birla health insurance policy, i don't want this policy please as soon as possible resolve my queris and close this health policy

I had made health insurance policy - active health insurance policy - plan name : platinum - essential, policy no.[protected], member id[protected], proposer"s name: shyam sundor sarker, insured person" name : sharmishtha sarker on 29.12.2018. Before doing the policy, i had contacted aditya birla health insurance office and sri rahul roy, sales executive, from their kolkata office had talked to me over telephone in detail regarding the above policy when he had assured me that my daughter, the insured person, will get all types of maternity facilities after 48 days from the date of starting of the policy to which i had been attracted and decided to start the policy. On receipt of the original policy bond and on going through the maternity portion it is seen the insured person will get the maternity facilities after waiting for 48 months in stead of 48 days. At once i contacted the concerned person sri rahul roy when he had assured me that the policy bond has been dispatched inadvertently and a fresh amended/rectified policy bond will be despatched very shortly. But today is 6th january, 2019, the amended policy bond has not reached to me. Whenever i contacted him, he is giving baseless/fake assurance to me. At last it has been clear and transparent to me that he is misguiding me in this regard and no amended policy bond will never be dispatched by the company.in a nutshell, i want to point out he has cheated me in this regard. I have repeatedly written to the company in this regard but they are not replying to my letters. Hence, i want to know why the concerned person, sri rahul roy, of aditya birla health insurance has misguided/harassed me in this regard. You are requested to do the needful in this regard so that amended/rectified policy bond is issued me as early as possible as assured my sri roy or refund back the amount deposited to them as first policy premium