| Address: Ahmedabad, Gujarat, 382213 |
Sir,
I am mr. Jitendrasingh babu singh, s/o babu singh, aged 36 years, resident of fairdeal jumbo packaging pvt. Ltd., plot no. 174, paiki, vill chacharwadi vasna, sarkhej bavla highway, ahmedabad 382213.
On 23rd november 2018, i have submitted a claim against the above policy (Claim no. Rr-ci[protected]. The claim is made in relation to acute myocardial infarct suffered by me, for which i was admitted on 14th november 2018 and was treated for the same.
Hdfc ergo (Hereinafter “the company”) has subsequently rejected my claim against the above policy, under section 1 i of the policy terms and conditions which states that the claim is payable only if the critical illness which the insured person is suffering from, occurs or manifests itself during the policy period as a first instance. My claim was repudiated on the basis that the date of inception of policy is 19th july 2017 and the cause of myocardial infarction, which is dys-lipidaemia, is there since 1.5 years; and hence, the ailment is pre-existing in nature.
I provide all proofs to company that i donot have any past history for that, but company people harrassed me and confused me and record a wrong statement and reject my claim.
Now again i refute the company’s decision to reject my claim for the following reasons:
1. I do not have any previous history of dys-lipidaemia, and, my claim does not fall under section 1 i of the policy terms and conditions. The surveyor who came to verify my claim misguided me and misunderstood my speech regarding the cholesterol levels and recorded a wrong statement.
2. My cholesterol levels have always been under control, until this incident on 14th november 2018. The certificate provided by dr. Chintan m. Sagar and the lipid profile reports of 13th february 2018 and 24th september 2018 clearly show normal levels of serum cholesterol.
The certificate provided by dr. Chintan m. Sagar is attached herwith as annexure a. The report dated 13th february 2018 is attached herewith as annexure b. The report dated 24th september 2018 is attached herewith as annexure c.
3. I have also filed a claim with hdfc ergo in september 2018 (Claim no. Rr-hs[protected] against policy no. [protected] when i suffered dengue fever in that month. I had submitted all medical reports along with this claim as well, which also showed normal levels of serum cholesterol. Report attached herewith.
Notwithstanding that i have submitted all required evidence; the company has rejected my claim. These rejections have been unreasonable and it appears that there is a deadlock. I hereby request the company to pass the amount claimed by me.
My claim is duly covered by the above policy as i suffered the acute myocardial infarction during the policy period.
I am very disappointed from hdfc ergo that i am a reguler policy holder from last 03-04 years, and company denied my genuine claim.
I am in tension due to this and mentally distrubed.
Now again i requesting to consumer form please do needfull.
Annexure:
A. Certificate issued by dr. Chintan m. Sagar
B. Laboratory report of ashirvad pathology laboratory, dated 13th february 2018
C. Laboratory report of aarya pathology laboratory, dated 24th september 2018
HDFC ERGO General Insurance customer support has been notified about the posted complaint.
Feb 13, 2019
Updated by jitubanna hdfc ergo is tottally fraud company, today a representative call me and said our stand is same on deny the claim.
at the time of selling policy they give big promises but at the time of claim they show neglancy. hdfc ergo surveyor misguided customer and take statement afterthat they reject the claim.
i submit all proofs but hdfc ergo deny my claim.
now i am going to file a case in consumer court against HDFC ERGO.
HDFC ERGO please don't make fool the people.
it is tottally fraud to me.
