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[Resolved]  United Healthcare — Non refund and misleading

I have been purely cheated by United Healthcare Insurance. My mother was admitted into M S Ramaiah hospital, Bangalore on the advice of the doctor because she was suffering from acute weight loss(15 kgs in a month), and weakness to the extent that she was unable to move around. The investigation tests on her showed multiple problems including abnormally high calcium content, high sugar, nodes along lungs to name a few. She was regularly given saline and insulin dosages apart from a few medicines. Meanwhile I shifted her from general ward to special ward as the insurance company boasted of providing for that in my policy. After 4 days, she was discharged with advice on taking the treatment 'further' for Sarcodiasis. I had signed on the cashless insurance claim form on the 1st day itself. The insurance company kept delaying it by a few queries. On the final day, at the time of her discharge, they denied it saying that she was admitted only 'for investigation reasons'. The doctor immediately wrote back a re consideration letter citing the acute reasons for her admission. It was again rejected citing the same reason. I called up the person handling my case - Mr Abhijeet who initially denied having received any reconsideration letter. He later found it. Then he asked for investigation reports. By this time, my mother had already been in the hospital for 6 hours waiting for her discharge. I immediately sent back the investigation reports at 6 pm. Mr Abhijeet said that he would get back to me by 8 pm, then 9 pm and finally no response. So the patient had to stay in the special ward for 1 more night. Today morning,Mr Abhijeet agreed that the reports were positive but wanted to know the 'treatment' for the disease. He again rejected the insurance. In spite of having less than required medical knowledge, he wanted to speak to my doctor. My doctor spoke to him and hen he wasnt medically capable enough to refute claim , he said that he would connect my doctor to the doctor from the insurance side. It was already 12 pm - 25 hours since my discharge. Ultimately, the claim was rejected as Dr Puja from the insurance side said that 'diabetes' treatment was not covered. She also told my doctor that the insurance company had already mentioned this to me earlier. I had to pay more than 40,000 for this, not to mention the frustration and mental harassment of the patient and the family. I would advice people not to go for this insurance in particular. They are too inhuman to be associated to medical and health.
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Complaint marked as Resolved Aug 13, 2020
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    Bangalore
    Karnataka
    India

    Complaint categoryCategory: Insurance
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