[Resolved]  Icici Lombard — reimbursement claim deduct

Address:700091
Website:www.icicilombard.com/IL-Health-Care/Customer/ClaimStatus

Dear Concern,
I Angshuman Dutta, working in "Core Integra Consulting PVT LTD" My employee code:- 10520.

I have hospitalized 2 times at AMRI salt lake, Kolkata dated 1st time on 31st Aug 2017, 15th Sep 2017.

I have already paid to the hospital but I asked for reimburse to ICICI-Lombard my corporate policy.

They deducted all amount which is mentioned below.

The details you have asked for is mentioned below.

As I informed you earlier below mail also mentioned another time.
I have submit all medical related bill. Though some amount have deducted.

1) 10% copay for submission of claim with in this days, Is there any clause in IRDA ? If the please send me in mail.

2) 3420 rupees deducted as EEG.glucometer report is not furnished. ALL DOCUMENT I HAVE SEND BY HARD COPY TO REFERENCE ADDRESS.
It is your responsibility to search and find out the paper and reimbursement the claim.

3) 7260 rupees deducted as deducted proportionate deduction.
Explain how many way you have deducted by room rent capping?

4) 6000 rupees once you deducted as room cap in 1st point.
Another 3850 deducted as room cap.

5) All MRD document I have send by courier to your reference address. Please find the hard copy of MRD record or MRD dept of AMRI hospital salt lake, KOLKATA.

6)The amount of ambulance bill and pre and post hospitalization medical test bill is not added with total amount till now.

Please note, The UHID no is IL[protected] as per claim form.

Please added the (ambulance bill and pre and post hospitalization medical test bill ) the all amount with total amount.

Please solve the problem expeditiously.
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Feb 9, 2018
Complaint marked as Resolved 
ICICI Lombard customer support has been notified about the posted complaint.
Verified Support
Jan 04, 2018
ICICI Lombard Customer Care's response
Dear Angshuman,

We apologize for the inconvenience caused. We will check this from our end and get back to you on it.

Regards,
ICICI Lombard General Insurance
Verified Support
Jan 04, 2018
ICICI Lombard Customer Care's response
Dear Sir,

We write this with reference to your below concern,

We would like to inform you that we reviewing your claim with our senior claims official and we will revert you within maximum 4 working days i.e. by January 10, 2018.

We request your co-operation in the interim and look forward to serve you.

Regards,
ICICI Lombard General Insurance
Verified Support
Jan 09, 2018
ICICI Lombard Customer Care's response
Dear Sir,



We write this with reference to your below concern,



We have reviewed your claim with our senior claims official and would like to inform you that as per the policy you are eligible for Rs.1500 per Day (Inclusive of Nursing charges).

Total Hospitalization is for 5 days(i.e.) you are eligible for RS, .7500, but as per the final bill room rent was charged for RS.40000.

Proportional deductions=Eligible/availed=7500/40000=0.1875(Appx)

Hence, we have applied this proportion on the total final bill except medicines and consumables.

Please note that as per policy terms and conditions in the event of the insured getting admitted in a category higher than the room rent cap, then the insured will bear the difference of all the medical expenses as in the final hospital bill in the same proportion.

We value your relation with us and assure you best of our services.



We look forward to serve you.

Regards,
ICICI Lombard General Insurance
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