[Resolved]  FHPL — denial of claim

Address:

New Delhi, Delhi

Dear Sir/Madam I am an HDFC BANK employee (employee id C1339), I have an health insurance with fhpl I have got admitted in FORTIS HOSPITAL NOIDA on 21/08/2014 as per doctor's advice as I was spitting blood from my mouth (as per doctor's I was suffering from hymoptysis), now your company is rejecting the claim as there was no need of hospitalization. I followed the fortis doctor's instruction if your company has any issue than you need to resolve it from fortis hospital team as I was the patient and I have to follow the doctor's instruction as I am not the doctor and I don't understand what kind of treatment or medicine I require, that's why the doctor's are . And there was a team of doctors who was taking care of me .So it means you are questioning the doctor's knowledge. I am in financial hardship and 72000 rs is a big amount for me I am going through a mental stress and it is affecting my health as per me I was sure that I have an insurance policy and your company will take care of it I look forward to hearing from you and to a resolution of this problem, Else I have to go to IRDA and consumer forum for the same . Claim Under Policy No. 020400/48/14/41/00000057 with Card No. 11635320 Name of Insurer: United India Insurance Co Ltd Name of the Insured Person Charul Shukla Claimed Amount: Rs.72247 /- Claimed for Hemoptysis Hospital Name: Fortis Noida Claim ID: 602512 Employee ID: C1339 Date of Admission: 20 Aug 2014 Date of Discharge: 23 Aug 2014 Received Date: 05 Sep 2014 Relation: Self Diagnosis/Type Of Treatment: Hemoptysis Dear Mr. /Ms. Charul Shukla As per the instructions o[censored]nited India Insurance Co Ltd your claim is being denied for Rs. 72247 on account of Hemoptysis for the reasons mentioned below . For any further clarifications you may please contact the insurer directly. 1.As per our medical opinion and submitted documents, the present hospitalization is for the investigation and evaluation of the ailment only. The investigations could have been done on outpatient basis without the necessity of admission for the same. Hence we regret to inform that your claim is repudiated. We have retained the claim papers for further references. In case you need further clarification or assistance, Please refer the above ClaimID for any further correspondence. You may write to us or send an email at [protected]@fhpl.net or speak with our 24X7 customer call center on [protected]. Thanks and regards Charul Shukla mob-[protected], [protected] Alternate email [protected]@yahoo.com