Icici Lombard — reimbursement health claim not fully settled | |
After contineous follow up by me, result came was shocking. I was unsatisfied by claim settled at your end. I have borrowed money from my colleuges and family for this operation. As a result i have to give back single penny to them. This is my corporate policy. From start when i reached and talk to the executives of icici regarding my Operation at bhuvika, they said not to worry - this policy also reimbursement post and pre operations. Now when i look back, i am totally be-fooled my self as not to operate at hospital where this icici Policy panel works, as my home conditions not allowing me to go very far from home. So i decided to go with bhuvika hospital. Also doctor assured me for better treatment. On the whole - i need full settlement of my claim - i need my single penny-as this is not my black money. I need a solution from your end. Whatever document you require - i will provide you Regarding disallowed amount — For ot charges-1000 Room nursing charges-1500 Surgery charge — 26317 (Not agreed at all) At last, i only say - whatever document you want, i will provide you - if you want me to come to Hyderebad i will be there- But i want full assurance from your end. Please revert asap. I am very much unsatisfied and on my toes. Thanks and regards Satish chand sharma On tue, 28 sep 2021 20:48:49 +0530 [protected]@icicilombard.com wrote Settlement letter Date : [date] To, Satish chand sharma Ashish goel, mirza internatonal limited, 01a ecotech-1, extension-1, uttarpradesh noida- 201308,, noida, uttar pradesh, 201308 tel: [protected] mob: Dear satish chand sharma, Claim no al no employee/member id employee name member name uhid [protected]satish chand Sharmasatish chand sharmail[protected] Doa hospital name requested amount net sanctioned amount co-payment amount disallowed amount Disallowed reasons 22-jul-2021bhuvika medicare[protected], deducted as per room Eligibility,, rs.8000/- septoplasty charges as not payable, deducted as sublimit exhausted,,, deducted as Sublimit exhausted, Note: if there are any deductions due to non-submission of reports or bills, the same will be re- Considered upon submission of required documents. Please submit the required documents within 30 days From the receipt of this letter. On behalf of icici lombard general insurance co. Ltd, we thank you for preferring icici lombard as your Health insurance partner. We write to you with reference to above health claim number, we wish to inform you that we have Received the papers & documents submitted by you. We have perused the documents and your claim is being Settled for an amount of rs. 35000. We enclose acheque/ eftvide ref. No. Cms[protected] dated 27-sep-21 Towards the full and final settlement of the claim. This includes an amount of 0 towards the service Tax & education cess, against the claimed amount of 0. The amount deducted under tds is 0. The company Hereby stands discharged of liabilities arising out of this claim... thank you for having given us an opportunity to be of service to you.in case of any further Clarification, please feel free to write to us at the below mentioned address, or e-mail us at [protected]@icicilombard.com according to your preference, quoting the above claim no, and we shall be Pleased to assist. In case you are not satisfied with the resolution provided, you may visit our website https://www.icicilombard.com/content/ilom-en/ServiceCouncil/SQindex.html for grievance redressal Procedure and insurance ombudsman office details for the resolution of your grievance. Associate vice president - health claims For icici lombard general insurance company ltd Icici lombard health care Contact details:email: [protected]@icicilombard.com Address: contact us Icici lombard gic, icici lombard health care, icici bank tower, plot no 12, financial district, nanakram guda, gachibowli, hyderabad – 500032, telangana irda registration no. 115 toll free helpline no.: toll free fax no.: fax no. Line 1: fax no. Line 2: 1800 2 666 [protected] [protected] [protected] ; Annexure i :[protected] Claim no :[protected] al no : Uhid no : il[protected] relationship :! Self Name of the patient : satish chand sharma Policy start date : 14-dec-20 policy end date : 13-dec-21 Type of claim : fresh claim requested amount! In rs :& Nbsp; 63817 Name of hospital : bhuvika medicare address of the hospital : b-194-a, lohia nagar ghaziabad, uttar pradesh-201001 Date of admission : 22-jul-21 date of discharge : 23-jul-21 Policy no : 4016/x/[protected]/01/000 Policy name: mirza internatonal limited number of! Insured& Nbsp;: Sum insured: 500000 total amount of claim settled! (Only pa Id claim): 35000 Balance sum insured: 465000 number of claims sett! Led till Date: 1 Accrued / additional sum insured: 0 due date of r! Enewal&nb Sp;: 14-dec-21 Renewal payment frequency: single grace period (A! Pplicable For renewal): 30 days sr no charges details claimed deductions paid reason for deductions 1anesthesia charges[protected] 2consultation visit charges[protected]consumable charges[protected]operation theatre Charges[protected]deducted as sublimit exhausted 5others3000300 5others[protected] 6room nursing Charges[protected]deducted as per room eligibility 7surgeon charges[protected]rs.8000/- septoplasty Charges as not payable, deducted as sublimit exhausted &n Bsp;total[protected] Diagnosis : other disorders of nose and nasal sinuses Final amount settled in rs. : 35000 Claim status : paid Was this information helpful? | |
ICICI Lombard customer support has been notified about the posted complaint. Verified Support Oct 04, 2021 ICICI Lombard Customer Care's response Dear Satish, Apologies for the inconvenience caused. We have made a note of the details mentioned. We will check this from our end and get back to you with an update on the same Regards, ICICI Lombard General Insurance Verified Support Oct 19, 2021 ICICI Lombard Customer Care's response Dear Mr. Sharma, Thank you for contacting ICICI Lombard General Insurance Company Ltd. We write this with reference to your claim status. We would like to inform you that the claim amount of Rs. 35000/- has been paid on 27th September 2021 with UTR no. CMS[protected]. We look forward to serve you. | |
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