[Resolved]  Tata AIG - Criticare Policy — Denial of claim

Address:

East Delhi, Delhi

Myself Shivani Gupta, being a regular premium payer of numerous health and home insurance policy of TATA-AIG , had an attack of facial paralysis on the right side of my face on 9th july 2011 . for the same , i submitted my claim documents to the claim department of TATA-AIG vide Claim #[protected] and Policy #CCP[protected] , after 30 days of survival of this illness . My neurologist DR. Rakesh Aggarwal senior neurologist in Indraprastha Apollo hospital Delhi) gave me the required certificate of diagnosis to claim my cover amount according to this criticare policy .( PLEASE NOTE the only thing i require is the diagnosis of the symptoms of any of the 11 illnesses of which paralysis is one) before my right side of the face could recover fully the paralysis shifted to the left side of my face damaging the 7th CARNIAL NERVE of my brain again and this time even more severe along with numbness in my knees and electric pain in the back of my neck even after various tests and MRIs nothing concrete would be found out , so I wasn't sure of getting any improvement as the symptoms’ were increasing . PLEASE NOTE THAT I'M JUST 21 YEARS OLD GIRL, with a deformed face and risk of having paralysis spread into my body parts as well . The doctor have already suggested me to get hospitalized as the symptoms’ are increasing .
All I’m asking from TATA-AIG is to stick to the commitment they make to us while selling their policy to us. After filing my claim I received a call from Dr. SUNIL GALA (manager claims),. PLEASE NOTE he confirmed details from me and I told him that I'm suffering from FACIAL PARALYSIS and he replied that he'll take 7-8 days to process the claim. I was, meanwhile, in touch with the customer care executives, to track the status of my claim as my condition was getting worse and doctor had already told me to get admitted if you feel numbness in other parts of the body. I did not get admitted in hospital as this is not a cashless policy and I certainly required funds as this deadly disease might ask for expensive treatments. But when I received a denial letter from Dr.Sunil Gala , stating that their definition of paralysis is total and complete loss of BOTH ARMS AND LEGS, I felt cheated and lost . On one hand the policy states that diagnosis of symptoms will make me liable for the claim and now they are completely turning a blind eye to me saying that I shall lose both my arms and both my legs to fit into their definition of paralysis. Nothing of this sort was ever mentioned in the policy documents I have. Any person, buys a health policy for their safety and security, they pay nearly half of their salary , in a hope that i[censored]nfortunately, some mishap occurs, they are safeguarded by those policies. I request Tata Aig to stick to the promises they make, while their sales executes get after our life to buy those policies which do not help us in the time of need.