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