[Resolved]  Indian Health Organisation — Not able to sumbit mediclaim

Address:

Coimbatore, Tamil Nadu

Hi, I am a very disturbed policy holder of IHO. On 22-Nov 2014, I was approached by a IHO executive and offered me " Freedom Gold Plan" . During the call he had told me that the concession on hospitalisation would be 55% and I will have to pay 45%. He said that the offer was available only for that day and rushed me into the plan. SO I paid Rs 4950 immediately to become a member. After that the next day when I visited the website I saw that the concessions were only 15 % to 20%. The 2 people who sold me this plan were Shweta and her boss Sanjiv. So I did not accept the verification call. I wanted to cancel the card. I kept saying hat I want to cancel the card and my refunded. Shweta then called up and said that there are so many other benefits and it is worth the money. Also if I do not accept the card, it will go in an infinite loop. SO I should atleast accept the card and then return back if I am not happy. But if I do not accept the card, I will never get back my money. So finally I accepted the card. On receiving the card, I wanted to check the services. So I requested for my Mother's Freedom Healthcheck package which is done through Thyrocare on 24-Dec-2014. I was told to pay Rs 200 as service charges (again which was not informed earlier). I was told that this service is taken care in the package. But I just went ahead and got it done by paying Rs 200. Then in Feb 2015, My daughter was not feeling well. So I raised a request for Doctor's home visit. I was told that this facility is not available in Coimbatore. SO I raised a complaint that if all these facilities were not available in Coimbatore, why was this plan sold to me saying that all these facilities are available in Coimbatore. Then one lady executive by name Rashmi ( who sends out mail from the mail ID Bhaskar Saini<[protected]@ihomail.com> approached me, tried to understand the problem and after many telephonic discussions offered me a mediclaim policy Family Gold Plan for my myself and my Mom. She said that the I cannot claim for any hospitalisation till 30 days except for accidental cases. After 30 days I can claim for hospitalisations. And so I took up the membership by paying Rs 6495 on 9-Mar-2015. On 1-Apr-2015, I had to get admitted in the hospital for some infection and so I called up the IHO customer care to inform them that I am advised by the doctor to get admitted for some tests. I am being informed that I will not be able to make this claim as I have not been given the insurance number yet. I asked them Ok fine, once I get the insurance number, I will send the claims as I was told that I can use after 30 days of membership. But i was told that I can claim only after an insurance number has been provided. That makes it 60 days of claims cannot be made. I asked why is it so and why was I not informed about this. They said this is how it is and stopped taking my calls. Also the executive (Male customer care executive) speaks as though they are giving us charity and we are taking their services for free. he talks so rudely. I feel cheated. I told them that if my concern is not addressed I will make a complaint. They told I can do whatever I want. Now after getting discharged from the hospital and better health, I am writing this to you. I have informed them that I will also be writing this same mail to consumer forum and IRDA also. Please help. Thanks Nita