[Resolved]  Icici Lombard — rejection of cashless claim

Policy number :4128i/ihpr/[protected]/02/000
Name :a k jain
Al no :[protected]
My father, mr. A k jain, was rushed to emergency on 26/1/18 at max hospital, sector 19, noida. He was diagnosed with acute severe headache. We did not intend to admit him but the hospital insisted that we should get him admitted as they would need to run several tests including mri & ct scan as this matter could be serious as it is related to head & might be related to brain we got him admitted to a single room & applied for cashless claim under above mentioned policy number of icici lombard. They rejected our claim stating that icici lombard has signed an mou with max hospital that cashless claims would be process for twin sharing room categories & below. Then we got mr. A k jain shifted to a double room from a single room because of the information icici withheld from us. We were not intimated about this while taking the policy or afterwards we have already declared hypertension in mr. A k jain's policy. We furnished icici lombard with all the relevant documents for the purpose of getting the claim. He was diagnosed with diabetes last year for which we even furnished them with a prescription from last year which. Icici still rejected our claim stating that they needed history of his diabetes & hyperlipidemia. We gave a signed & stamped letter from max hospital that he no history of hyperlipidemia & he is having diabetes for last one year. Icici lombard regarded this document as irrelevant they made us wait from 12 am - 6pm on 28/1/18 for the purpose of processing the claim, which they rejected in the end. They traumatized the patient by continuously calling him. They traumatized me by making useless remarks for the purpose of rejecting the claim. I must have called them atleast 10 times on 28/1/18 to know the progress, continuous argument with their staff gave me a severe headache because of which i got really unwell.