[Resolved]  Bajaj Allianz Life Insurance — Claim Under Mahila Gain and HCB Riders

Dear Sir,

I have purchased “Invest Gain Platinum” Insurance Policy no. [protected] before three years and now I am facing a big problem with this.

Three years ago, I need a medical policy or Insurance where cover the pregnancy case but not any medical policy covers the pregnancy case. So one day, one of the agent of Bajaj Allianz told me about this policy that this is only one policy where cover the pregnancy under MahilaGain Rider. Also he told me that this policy paid “Hospital Cash Benefit” for 48 hours hospitalization. I impressed and purchased the policy. Now when my wife CHAROO (Policy Holder) delivered a baby. I claim to the company to reimburse the payment under “MahilaGian” and “HCB”.

Company Rejected my claim and mentioned the reason in a letter for HCB:- “Room rent charged is not exceeding 3 days hence, the hospital cash claim has been rejected as non-admissible”. And for MahilaGain Rider:- “The Medical papers submitted by you do not indicate any complication in pregnancy which is not covered under MahilaGain. Hence, the MahilaGain Claim has been rejected as non-admissible”.

So now (after three year), company providing me knowledge that if there is any complication in pregnancy then it covered under MahilaGain and if three days (72 hours) of hospitalization then it covered under HCB. But for HCB the agent still telling me that when we purchased this policy, that time HCB was covered for 48 hours, but now the company changed their terms without any notification. And for MahilaGain Rider first of all I will told you that our pregnancy case was more complicated than the cesarean as per the doctors and hospital. Doctors has taken our case on a “High Risk Pregnancy” and used the Vacuum, Tools, Foetal Monitoring and other equipments to make a normal delivery, which we want to the hospital. So the usage of these tools makes this normal delivery case more complicated than the cesarean. This was the very complicated case as per the doctors and hospital. Look at the hospital discharge summary and bills submitted by us. Or show the papers to any hospital or Gynecologist and ask them that, Is this complicated case or not?

I am requesting kindly recheck my papers and settle my claim


Thanks

Mohan (Charoo’s Husband)
Cont. [protected]