ICICI Prudential Life Insurance — Below Par Claim Settlement

Address:

Malad East

Policy No:[protected]Mediclaim Policy

Claim No: CL9376912

Sir,

With reference to our above claim & policy, in spite of repeated attempts with your Mr. Namrit Shah & Mr. Mohit(contact person from ICICI), we have not been paid our full claim as per the circular of inclusion of COVID-19 in our policy of Hospital Care II. In spite of repeated meeting with the above-mentioned people, they have not been to solve our query. Upon asking for clarification as to why our claim has been passed for such a low amount, we have not received satisfactory answers.

IRDA Circular also states that you have to pay as per the guidelines of COVID-19, which is included in our policy mentioned above. What we have received is only ‘daily hospital cash benefit’ We have not received any claims for the COVID-19 treatment.

I am the holder of this policy since past 8 years and renewing it every year. As COVID-19 is new and is included in our policy, it has to be categorised based on the severity. One in every 5 people admitted to the hospital of my age group dies. Which is a 20% ratio as per the statistics available in the market. Hence, it is as severe as any life-threatening surgery. Hence, it should be considered in the Severe Category. Any claim pertaining to COVID-19 should be settled with maximum pay-out. Which we have not received.

Our claim was for Rs. 5, 80, 000/- approximately. Actual claim passed was of Rs. 43, 000/- (which is the daily hospital cash benefit). Claim for the treatment of COVID-19 has not been considered at all.

Thank you

Devraj B. Pipalia