[Resolved]  ICICI Lombard Health Insurance — Refuse to provide cashless hospitalisation

Sir/Madam,

My name is John I. Rayhan. I am a professional of age 31 years working with an IT MNC in Delhi/NCR. I am an ICICI Lombard health insurance policy holder. Its a Family Floater Health with policy no. 4034i/FFH/W-560906/00/000 where my wife and me are covered and the sum insured is 4 lacs each.

I had an accident on 24th March and I got admitted to Moolchand Hospital with broken legs. Since, Moolchand Hospital is among the network hospital for my medical insurance so I take the pain to travel to this hospital which is 10 km from my place rather then getting admitted in a hospital near my place. I did so because I want to get the cashless benefit of my policy.

I applied for the cashless hospitalisation on 24th March as I need to stay in the hospital for few days because I need to get operated to fix my fracture and leg.

The hospital authority got the response from ICICI Lombard and they send a query that they need something called MLC (its a document from local police authority). The hospital authority and the doctor who was doing my treatment responsed back and fax them a documents which they stated that in my case no MLC required as its not a road accident and no police is involved and also its not a case related to alchohol consumption.

My doctor had to postpone my surgery for another day as I didn't get the cashless hospitalisation approval even after 24 hours of my addmission.

So, i talked with the customer care guys and explain then my situation and how the accident takes place. The were convinced as ask me to send a letter from the hospital authority with duly singned and sealed which should state that in my case no traffice accident or police is involved and so no MLC required. The hospital authority did the same the very next day and they took me to the operation theatre.

My wife keeps on doing follow up with the customer care people to check the status of my request. But to everybody's surprise they didnt bother to approve my cashless hospitalisation. My doctor even took the pain to talk with ICICI Lombard but no positive request.

So, I was really haressed and mentally pissed off after my operation. I waited for another day after my operation but nothing happens. The sequence of sending query and responses keeps on going and these ICICI people didn't approve which was my right as I am a policy holder. So, the doctors decided to release me on 28th from the hospital and I need to pay all the bills around Rs. 94, 000 inspite of the fact that I have a health insurance which covers the treatment and I was in the network hospital.

Now, I need help and justice to fight against these financial institute which cheat people with their big promises and poor customer service.

Please help me!!

If you want you can contact me at [protected].

Thank you in advance for your time and interference.

Regards,

John I Rayhan