[Resolved]  Reliance General Insurance- Floater policy — demanded indor patients indoor case history after 5f months of lodgement of claim

Address:

Bharuch, Gujarat

We have longed mediclaim of 7 years baby girl, who is admitted in hospital for 3 dyas due to jhondies. We have intimate the company and the intimation is 47223. After discharge from hospital we sumitted the documents to claim the reimbursement of medical treatment expenses including hospitalisation. exp. After 6 months of submission and after many follw ups we received a letter mentioning "Valid clarification for infusion and injection charge as nursing charge given. Kindly provide the certified copy of day to day indoor case papers with history sheet". We submitted the doctor's certificate. However the indoor case paper was not available as the 5 months have passed & the patient was cured and it cannot be generated after 6 months.
If the indoor case history was requested at the time of lodgement of claim, we could have submitted the same in time. , If there is a doubt, the company can inquire at hospital. But the case was denied on the ground that the indoor case history is not there. The calim amount is of 23000/-.
So pl. look in to the matter and do needful.

You can go through the communication we with reliance General Insurance.

Fw: Re: Fw: Intimation of Hospitalisation - 47223. (Case ID:[protected]
1 recipientsCC: recipientsYou MoreBCC: recipientsYou
Hide Details FROM:Reliance General Insurance Company Limited TO:MAHESH G PATEL Message flagged Monday, 30 January 2012 7:54 AMDear Customer,



Thank you for contacting Reliance General Insurance.



We apologies for delay in responding to you.



With reference to your complaint, your claim has been closed due to non submission of claim documents. Kindly contact your TPA for further processing.



You may also contact our free or[protected]local charges) for further help. Our contact centre is reachable between 8.00 AM to 9.00 PM (7 days a week).



Warm Regards,




Customer Service Team

Reliance General Insurance Co. Ltd.

Corporate Office - Mumbai
Helpline:[protected]

www.reliancegeneral.co.in



[protected]Original Message[protected]
From: adinath.[protected]@yahoo.co.in
To: services.[protected]@relianceada.com
Subject: Fw: Re: Fw: Intimation of Hospitalisation - 47223. (Case ID:[protected]


Dear sir,


Thank you for informing us regarding status. But I am not happy with your services. I have asked for the status to know if any documents are required or the claim is passed and we will get the claim amount. Instead, you are, after 6 months, informing that the claim no,5864175 has been repudiated by your claim team.


This is really surprising that you are responding after 6 months and informing that the documents are not submitted. When the documents are demanded for after submitting the claim file. Actually we are awaiting for the claim amount as there was no query


Pl look into the matter and reply soon in a positive way.


Regards,
Mahesh G Patel.
----- Forwarded Message -----
From: Reliance General Insurance Company Limited
To: MAHESH G PATEL
Sent: Saturday, 21 January 2012 1:45 PM
Subject: Fw: Re: Fw: Intimation of Hospitalisation - 47223. (Case ID:[protected]



Dear Customer,
Thank you for contacting Reliance General Insurance.

We regret to inform you that your claim no. 5864175, has been ‘Repudiated’ by our claims team.
Reason for closure:Non submission of documents
Details of documents : Valid clarification for infusion and injection charge as nursing charge given. Kindly provide the certified copy of day to day indoor case papers with history sheet.

If you wish to persue the case further, you may write to our claims department on the address mentioned below:

Reliance General Insurance
Health Claims Team
570, Naigaum Cross Road,
Next to Royal Industrial Estate,
Wadala (W), Mumbai- 400031

In line with our focus and commitment to Customer Service, we trust we have addressed your service request in a fair and equitable manner and the issue has been resolved to your satisfaction. In accordance with regulatory guidelines, we are also required to mention that you may approach the Insurance Ombudsman; in the event you are not satisfied with our handling of your complaint.
Should you wish to exercise this option, please log on to our website www.reliancegeneral.co.in for details.

Assuring you of our best services always.


Warm Regards,

Customer Service Team
Reliance General Insurance Co. Ltd.
Corporate Office - Mumbai
Helpline:[protected]
www.reliancegeneral.co.in


[protected]Original Message[protected]
From: adinath.[protected]@yahoo.co.in
To: anuj.[protected]@relianceada.com, [protected]@mediassistindia.com
CC: [protected]@mediassistindia.com, services.[protected]@relianceada.com
Subject: Fw: Re: Fw: Intimation of Hospitalisation - 47223.

Dear sir,
Again I am forwarding this email to remind you that nither we received any claim sattlement amount nor any reply. So pl look in to matter and do needful at the earliest.

pl do reply after receipt of this email.

Regards,
Jayant


--- On Tue, 5/7/11, JAYANT DOSHI wrote:


From: JAYANT DOSHI
Subject: Fw: Re: Fw: Intimation of Hospitalisation - 47223.
To: anuj.[protected]@relianceada.com
Date: Tuesday, 5 July, 2011, 3:45 PM


Dear sir,
Kindly go through the forwarded and let me know the status of mediclaim.
Regards,
Jayant

--- On Tue, 5/7/11, JAYANT DOSHI wrote:


From: JAYANT DOSHI
Subject: Fw: Re: Fw: Intimation of Hospitalisation - 47223.
To: [protected]@mediassistindia.com
Cc: "reliance general insurance" , "rakesh mediaassit" , "Gaurang Upadhyay"
Date: Tuesday, 5 July, 2011, 3:43 PM


Dear sir,
Pl go thoruhg the forwarded email. Till date we have nither received any communication nor the claim amount . So pl look in ti the matter and let us know the status.
Regards,
Jayant

--- On Tue, 31/5/11, JAYANT DOSHI wrote:


From: JAYANT DOSHI
Subject: Fw: Re: Fw: Intimation of Hospitalisation - 47223.
To: [protected]@mediassistindia.com
Date: Tuesday, 31 May, 2011, 6:19 PM



Dear sir,
We have submitted the bills for claim about 25 days back in reference to the intimation No. 47223. However, we have not yet received the claim amount. Kindly look in to the matter and let me know the status.

Regards,
Minesh Patel
--- On Mon, 11/4/11, vanajakshibm wrote:


From: vanajakshibm
Subject: Re: Fw: Intimation of Hospitalisation - 47223.
To: "JAYANT DOSHI"
Date: Monday, 11 April, 2011, 11:15 AM



Dear Sir,

Kindly note claim intimation no :47223 & find the attachment of reimbursement claim check list.

Thanks & Regards,
Vanaja


--- On Fri, 8/4/11, JAYANT DOSHI <adinath.[protected]@yahoo.co.in> wrote:

From: JAYANT DOSHI
Subject: Intimation of Hospitalisation
To: "rakesh mediaassit" , [protected]@mediassistindia.com
Cc: [protected]@mediassistindia.com, [protected]@mediassistindia.com, "reliance general insurance"
Date: Friday, 8 April, 2011, 9:57 AM
Dear sir,
Ref : Policy no.[protected]
This is to intimate you that Ms. Palak M Patel is hospitalised on 6th April, 2011 at Sanjiv Hospital, Dr. Bharat mehta, Falsruti nagar Bahruch due to jhondies.
Kindly confirm the receipt of intimation and let us no the registration No. of intimation.
Regards,
MInesh Patel