[Resolved]  ICICI Lombard Health Care — Rejection of Hospitalisation Claim

Address:

Hyderabad, Andhra Pradesh

My claim No.[protected] was rejected by ICICI-Lombard since they consider this policy as 3rd yr policy.”

I would like to state that this is not a 3rd year policy as considered by ICICI-Lombard and it is now 5th year policy as Ias illustrated below :

Policy Taken on end of Year Year
23-Jun-07 22-Jun-08 1st Year
23-Jun-08 22-Jun-09 2nd Year
23-Jun-09 22-Jun-10 3rd Year
23-Jun-10 22-Jun-11 4th Year
22-Jun-11 22-Jun-12 5th year

I have been renewing my policy without any break sinde June 2007. This itself is aa testimony to the fact that it is now 5th year policy and not 3rd year as considered by them.

Please note that the above cashless mediclaim policy is renewal of my policy 4034/FPA/02321927/00/000 taken on 23rd June 2007 and I have been renewing this policy without any break. In this connection, I also would like to bring the following exclusions covered under the ICICI-Lombard Family Protect Premier Policy Wording under clause 3.1 and the relevant extract is reproduced below:

"This exclusion shall cease to apply, subject to the exclusions mentioned Sub-clause 3.4, if the Insured has taken a Healthcare Policy from the Company and has been covered under the Policy, without a break, for a period of 4 consecutive years immediately preceding the Period of Insurance"

Considering the above facts, the reasons given by ICICI Lombard in rejecting my claim is baseless and they have become more skeptical in settling my claim.