[Resolved]  Icici Lombard — Mental Trauma

Address:

Mumbai City, Maharashtra

ICICI LOMBARD HEALTH INSURANCE-FRAUD, CHEAT AND WORST MISTAKE OF MY LIFE
Before I start narrating my ordeal, let me introduce myself, I am an employee of ING Vysya Bank since the past three years, and having knowledge of all insurance products, I purchased ICICI insurance, but have been completely let down.
The past three days have been the most traumatic and worst experience faced by me and my family. My mother, Nafisa Jaliwala, most unlucky as being your customer by taking health insurance policy detailed below:
Plan name-FPR 2007
Policy number -4034i/FTP/05945469/00/000
Name of Insured-Shabbir Kamruddin Jaliwala and Nafisa Jaliwala
Agent Name-Prachi Singh –Agent Code id -2438605
Health member id-IHPN[protected]/02
She had a major accident on the evening of 14th November 2012, and the impact was directly on her head, due to which her head was spilt open and she lost ample amount of blood. We took her to Bombay hospital, Marine Lines, Mumbai at around 10.00 pm on 14/11/2012, considering its best in class for neurology and also it is listed under your “Cashless list of Hospitals”
ICICI Lombard nuisance starts from here:
• Irresponsible Agents
I tried calling Prachi Singh (ICICI agent in ING Vysya Bank, Mandvi Branch) , since I purchased the policy from her (as I was previously posted there), but her number was unavailable. I then called my friend to find out who is incharge of Health Insurance after Prachi Singh in Mandvi Branch of ING Vysya Bank and he gives me the name of another Agent named Ritesh (ph [protected]).I wanted to find out regarding cashless process and cashless list of hospitals. He did not help me in any sort of things and did not even assured to call me back after finding out the details. He only said “Sir main naya hun, Mujhe claims aur Cashless ke process ke bare main pata nahi,hum log sales ke bandhe hai”.
• Unhelpful Call Centre
The hospital wanted 60000/- as cash deposit for admitting my mother. I said that we are insured and Bombay hospital comes under Cashless hospitals of ICICI Lombard to which they reverted back is “we are not cashless affiliated to any health insurance and whatever you wanted to talk you should go to Marketing Dept of the hospital”. It was 11.30 at night and all dept were closed. I called the Customer care[protected]people I spoke to was Sagir,Kumar,Ghazala ) firstly I gave my policy number and the person said my system is down cant retrieve the data. Then I again called and told him that hospital is asking for 60000/- as deposit to which his response was “Sir that is not possible you only have to pay 5000/- or max 10000/- as deposit, you don’t have to pay sixty thousand”. I told him that they are saying we are not cashless hospital and for admission you have to pay 60000/-. It was 12.00 in the night, I did not have money and ICICI Lombard was saying that it is not possible, please contact TPA team which obviously was not working at that hour. One moment your customer care executive even said “Sir aap hospital change kar do”.
I was calling my relatives for money and literally at 12.00 at night went to relatives place for cash and begged the doctor to reduce the deposit amount. What is the point of Cashless if you can’t provide the facility. Your sales people tell us cashless and “Sir aapko ek rupaye nahi bharna padega” and they run away after selling the policy as their targets are done and we are stuck with useless and feeble policy and certainly useless and foolish Customer Care.
• “Cashless” is bogus
The Disturbance does not end here, went to marketing team of Bombay Hospital, next morning for “cashless” facility and a lethargic person gives me a cashless preauthorization form and tells me to get doctors sign before 3 pm, as they were shutting down by 3 pm.
He did not give me any info on docs required, which by now should be given by your customer care or agent, but nothing was given. The doctor came after 3 pm, and gives the signature and by now the marketing persons shuts down and leaves hence matter goes to next morning. I was speaking to Ms Ghazala (floor manager customer care) and told her that after you receive my preauthorization request kindly assist on urgent basis which she assured that time, but eventually took 4 hours by that time I paid the hospital bills and discharged my mother and yet there was no revert from ICICI Lombard.
This is the worst experience of my life and ICICI Lombard has not only, assisted but also added trauma to our existing problematic situation. You don’t have any knowledgeable customer care, have lied and cheated us by misspelling the policy and I am going to Sue you for such traumatic experience that i have faced because of ICICI Lombard Health insurance and don’t worry about the bad word of mouth publicity because it is going to be hugely broadcasted, and if I Don’t get any revert back my next mail is going to be directly to media and Consumer court and IRDA officials. Dont think of this as a threat but this will be my action for sure, because my mothers life was on stake and instead of aiding in such painfull situation I was just harassed and fooled by ICICI Lombard. Instead of being by my mothers side, I was running around the customer care, for no end result
There is so much documentation required at each step, that lay man will never be able to understand the processes
ICICI Lombard is in true sense cheaters and deserve worst punishment there could be possible and the only thing they are best is fooling the customers, lying to them and mis selling them products and looting their hard earned money.
Waiting for your reply

=
(On behalf of insured/patient Nafisa Jaliwala)
Aliasgar Jaliwala