[Resolved]  ICICI Lombard General Insurance — BEWARE OF HEALTH INSURANCE CLAIMS

BEWARE OF HEALTH INSURANCE CLAIMS


We hold ICICI Lombard General Insurance vide policy No. 4034/FNP/01964651/00/000 and we applied for Reimbursement Claim No BLC-02-08-CN-L13497 on 4th Feb 2008.


I had the worst ever experience in dealing with ICICI Lombard General Insurance and
TTK Health Care Services (P) Ltd, Mumbai the third party who handles the reimbursement.

I am going to write to you in brief as to what had transpired between me and TTK.

On 4th Feb 2008 I sent my claim papers to TTK Mumbai. Before sending my papers I called up the customer care of TTK and informed them that I do not have the consolidated bill except for the weekly bills along with the payment receipts. They said that would suffice so then I sent my first set of papers.

I received a letter dated 12/02/08 from TTK Mumbai asking me furnish the following information which I sent on 26th Feb 08.

REQUIRED ALL ORIGINAL INVESTIGATION REPORTS

REQUIRED ALL PRIOR CONSULTATION PAPERS WITH SUBSEQUENT PAPERS OF TREATMENT FOR FEVER ON AND OFF.

In that letter there was no mention of main hospital bills and receipts requirement which clearly indicates that my papers are in order.

I followed up with TTK every week and always I had a standard answer that my claim is under process. This went on for weeks and months. Its more than 3 months I submitted my papers. The best part is the Executive at the call centre never puts me on the higher ups. With great difficulty managed to get their Asst. Manager-Claims, Mr. K. Dhananjay who promised to do something. After repeated STD calls to Mumbai I was told Mr. Dhananjay was no longer with TTK. I was asked to get in touch with Ms. Nirjara, Manager-Claims whom I never got on line after repeated calls. Sent a mail to her. Till date awaiting her reply. There was no proper response from TTK hence I was forced to contact ICICI Lombard General Insurance in this regard. We contacted their supervisor Mr. Raju 15days back who gave us request no: 70508471 and promised latest that evening would settle the issue. That evening is yet to come. Disgusted got in touch with Mr. Jayanth who also promised but his promise is still pending

We sent a mail to Mr. Praful Karkera, Customer Care Unit, ICICI Lombard General Insurance, who wrote to me that in the documents submitted are inadequate. Why was TTK sitting on my papers all these months when there was no written communication from their end?


I don't have any documents to be submitted. Even if I am to submit the main hospital bill I need to return all the original weekly bills back to the hospital pay them the requisite fee and wait for 3 weeks for them to dispatch. They do not hand deliver. All my weekly bills are with TTK, Mumbai.

Because of this inordinate delay I am deprived of my claim from my other Insurance Agency. Every body needs the originals.

” I want to know only one thing”. WHY DID IT TAKE MORE THAN THREE MONTHS TO PROCESS MY CLAIM.

This is what Health Insurances are it appears. This is the saga of grieving parent over the insurance policy system. A normal expectation is insurance amount would come handy for treatment purpose. Far from that we are running pillar to post to get back the amount. Let readers decide and Beware of tall promises of certain Insurance Companies and not fall pray to false advertisements and claims by the company