[Resolved]  Cigna TTK Health Insurance — policy number prohlr[protected] claim rejected

Address:

Chandigarh, Haryana, 140601

I have purchase a health policy in july 2016 for my mother, unfortunately she got dengue fever and I hospitalized to Malik Diagnostic Center Panchkula on 19 Nov 2016 as doctor say platelet are very low. On next day he advice to get fresh platelet and somehow I manage donor and convert blood into platelet from Govt. hospital with paying their fee (Rs 8500). I also convey message to customer care when my mother get hospitalized. While investigating for more than two months still Company has rejected my Claim. While giving below reason:

The hospitalization documents suppress/ conceal/ misrepresent material facts about the ailment as per the documentary evidence available. Hence, the claim is not admissible under the policy condition.

The reason does not clear why claim has been rejected, after asking from customer care and grievance cell many time but they does not clear why it has been rejected and claim found to be fraud.

Many time medical office from their side from Chandigarh call me and ask additional documents and also visit to doctor bring some documents.

The additional documents ask by company was provided by me and they have acknowledge its confirmation, when they reject my claim I ask for documents they say we will not provide you, some time we are still searching, but till today I have not got any documents. Documents are original and I don’t have copy of that as I don’t know to keep Xerox of that, as I am new to that.

Company after investigation 4 - 5 month send me mail your claim has been rejected, still i don't know the reason

company has send me the below reason
(1) VIII.24. Fraudulent Claims ---- If any claim is found to be fraudulent, or if any false declaration is made, or if any fraudulent devices are used by You or the Insured Person or anyone acting on their behalf to obtain any benefit under this Policy then this Policy shall be void and all claims being processed shall be forfeited for all Insured Persons. All sums paid under this Policy shall be repaid to Us by You on behalf of all Insured Persons who shall be jointly liable for such repayment.

so don't buy any policy from Cigna TTK
also don't buy any policy from Easypolicy, i had purchase policy from their.