Address: | Kolkata, West Bengal, 700050 |
As per the assured benefits mentioned by the respective agent, i got interested hence registered for this above-mentioned policy for which i have been paying premiums since 7th august 2017.
On 26th october 2019 for the policy no :[protected] suddenly i was down with high fever with symptoms suspected to be dengue and on 27th october 2019, i had to be admitted to hospital as fever was not going down even after taking medications prescribed by the doctor. I was in the hospital for five days starting from midnight 28th october 2019 to the evening of 31st october 2019. During the initial three days, the doctors were suspecting it to be dengue which after proper reports turned out to be negative and it was a kind of viral fever as concluded by the doctors.
Now talking about the discharge summary the amount was rs.95845 from which i got the mediclaim amount of rs.64000 from heritage health insurance. I have not included the tests that were done in my home from a polyclinic which cost me rs.4540.
As per the agent description of the above-mentioned policy, he stated that every cost will be covered from medical expenses to lab test charges to hospitalization charges which as per my calculations stands out to be rs.100385 (Rs. 95845 + rs. 4540).
As per the standard procedure, the agent asked me to submit photocopies of the reports from the hospital with the discharge summary to get the amount of rs.100385 but whereas i received an amount of rs.4400 through neft on 17th december 2019. And two days later i received a mail where it was mentioned the benefits under the policy are not directly related to the actual expenses incurred by me now whereas mediclaim gave acceptance of the claim. As it is mentioned it is not directly related so why have you given me the amount of rs.4400, is it called the begging amount???
Now, where and how am i supposed to know that this disease is not covered in the policy the agent was supposed to inform us beforehand so that we would not have opted for this policy and most importantly i did not give an invitation to the disease to ail me so that i could claim the policy
I had sent a mail to the grievance cell in lic website to the executive director got no response from there.
Now writing my complaint here. Was this information helpful? |
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