Max Bupa Complaints & Reviews

My father purchased a policy in the year 2016 .at the time of taking my father's medical test was conducted and it has been specified that he is normal with slight sugar ..nothing in the medical test came for bp but being genuine I even disclosed that my father sometimes get high bp.i the year 2017 or 2016 Dec we got to know my father is suffering from renal failure .in 2018 my father was admitted in fortis hospital for kidney failure they declined my claim as well as now they have send me a cancellation notice for my policy.after his discharge again 4 days later be again got admitted for chicken pox and doctor clearly wrote that chicken pox is not related with sugar and bp but they send me a cancellation notice

Sir,
I had submitted 2 (two) claims in respect of pre and post hospitalisation expenses and vaccinations' expenses for my twin sons .Both of my twin sons had been treated similarly and pre and post hospitalisation expenses were also similar. They had been administered vaccinations by same doctors.While one claim was settled for Rs 6595/- initially, the other claim was rejected at the very first instance for reasons best known to Max Bupa Health Insurance Company. After repeated talks and emails the first claim for my son was settled for Rs 20400/- and the second claim was again rejected. After repeated requests the second claim was initially settled for Rs 1905/- only and later on after repeated calls and e mails it WS finally settled for Rs 13232/-
While both of my twin sons had undergone similar treatments and vaccinations the settlement for the two claims are not in similar lines.Both the claims have not been settled properly for reasons best known to Max Bupa.Moreover the Grievance Cell has not acknowledged my email in respect of my grievance.Also the Customer Care seems least bothered in solving customer problems as I had requested for addition of my two sons in the policy, but they had added only one son's name whilst the other was left out and to my surprise and dismay both the claims have been settled against the other son's name.
I have faced undue harassment by Max- Bupa, besides wasting my precious time.Kindly look into the matter and help me get my claim amounts settled appropriately, besides penalising the insurance company, so that similar treatment to customers does not recur by Max-Bupa.

I have taken policy for brother. while playing he suffered from knee injury. During hospitalization doctor suggested for ligament operation.

After that we applied for cashless but max bupa rejected cashless and suggested for reimbursement. After hospitalization we submitted all claim document. max bupa send message that within 21 days claim will approved. Now after 40 days also claim is not approved and showing Suspense status .

after that I checked review from many website, I come to know that max bupa claim ration is zero.

This is fake company who not settle any claim.

Below are my claim details:

Claim Number: 339012

Final Status: Suspense

Claim Decision Date: Saturday, June 9, 2018 12:00 AM

As an nri in saudi arabia, i'd keep in touch with the person i'd purchased my health policy from to know the status or request for services, via email or whatsapp — since it's makes no sense to make an international call for this. (The person's email address was on the company domain maxbupa.com)

One day my emails started bouncing back, with a message that the recipient address was no longer in use so i contacted the person on whatsapp — and learned that he had resigned.

Subsequently, i asked max bupa ([protected]@maxbupa.com) why i wasn't informed about this by them; in response, they apologized, and asked me to contact a specific agent, giving me his email address. (This address was on bsnl.in)

When i sent him an email to initiate contact, it kept bouncing back, indicating some error. I decided to communicate with him by phone when down in india.

At this point i assuming that this would go positively when i spoke to him...

When i did go down to india and contacted the guy, he said i could call him whenever i needed any service, so i reminded him that being in saudi arabia, i wouldn't want to make calls to india for this — unless max bupa would pay for my international calls.

I suggested we stick to emails, and when i asked why he hadn't responded to mine, he claimed that 'his computer hadn't been working for a long time.'

As an alternative, i said we could communicate on whatsapp, whereupon he stated that 'he wasn't familiar with it or using it.'

Exasperated, i asked him to give me some option to communicate with him from abroad — and at this point he assured me that his son was due to visit him soon, and would share his email address with him. (He also added that his son was doing his studies in computer engineering.)

At this point, i didn't know whether to laugh or to cry. I simply told him that i would contact him after returning to saudi arabia...

Once back i used sms to contact him many times but got no reply. Finally, i requested my father who's in goa to call the guy, & ask him for the address. The response my father got from him was very rude, as he described it.

I escalated this to max bupa and asked them to assign another agent to me, but i was told that their company policy doesn't let them reassign agents for such reasons, and so i was given the contacts of other people to approach.

You'd think that a large company has good standards and expectations in terms of employees — but seeing that max bupa employs people who don't even know how to use emails or whatsapp, i suppose that isn't the case...

This complaint is regarding application no.[protected] max bupa for health insurance. I wanted to get health insurance of my mother. Then we contacted max bupa health insurance, after few weeks they called us for my mother's routine checkup they just did blood tests, ecg and urine tests. Few weeks later we get a notice from max bupa informing they won't be initiating the procedure because my mother has enlarged lymph nodes. And let me tell you they didn't even inspect and palpate any thing. Just an excuse for rejecting the customer.

In october 2016 i was admitted to local nearby hospital to my residence. I was there for 3 days and when i send documents for claim, they denied. And when i asked for reason, they said its internal matter and we can't tell you. This is completely fraud company. I am porting to apollo munich now. They giving more cover amount and top up facilty then max bupa. Also, max bupa, raise policy premium every year. Apollo has age slabs and amount remain same.

Max Bupa has started its health insurance policies with lots of FALSE advertising. Their claim of covering everybody whatever their existing illness And all test will be done by there expenses is false. They charged Rs. 57, 907/- as premium before they could even issue policy for me, my spouse and kids. My wife has delivered twin kids one month before and told Max Bupa people regarding that and they told no worries we cover all. And They said they have to do some medical tests for my wife, and kids stating medical check up is free. And sent to a worst diagnostic center for test where there was no proper equipment and facilities. I complained them the same and they told dont worry about it we will take action for the same. After getting report from them they told we are sending the policy within 3 working days.For this process it was already 30 days. Suddenly one day they said your wife policy got rejected due to uterus issue. Immediately i consulted my doctor and he told for every mother who has delivered baby their uterus will be displaced for few weeks and it will come to its position after few weeks and its not a disease or major issue. But this people have rejected stating its underwriting policy without giving proper reason and they have deducted Rs.2000/- without confirmation or permission from me for medical test. I asked for the reason and they could not share the same with me and insisted that its company policy. The worst of all is that they are claiming to send online transfer of Rs. 55, 000 odd rupees and the balance they are claiming to be the medical test charges. Before conducting the medical tests, they have very clearly mentioned that medical tests will be conducted on the expense of Max Bupa and we did not have to pay anything.

ALL IN ALL ...A FRAUD COMPANY FULL OF LIES!!!

I have mailed to an executive called Mr.Amit and sachin who is a manager who is major hand in cheating my money and keeping me in dark giving false commitments.
Below are the mails which i have sent to them which is for your reference.

Below are the mails sent to Amit and sachin till date,

Dear Amit,

As you confirmed that entire amount which I paid for the medical policy will be refunded. But please find the attachment which says only 55k is refunded instead of 57k. So, I am registering a complaint against you, Sachin and max Bupa for cheating customers in consumer court and local police station. And sending detailed information to all media and social media. So, that no one should face this type of problems from cheaters like max Bupa online insurance and people who give wrong commitment to customers.
Thanks for max Bupa for cheating and without informing customer or taking permission from customer for medical check up charges and not providing the original reports of medical test . Let's world know about this and max Bupa will pay for it.

This is with reference to your health insurance application no.2616603, customer id [protected] and I have paid Rs.57, 907/- to Max Bupa Health Insurance Company Limited on 1/5/2018.

And today(24/5/2018) after 24 days you are sending rejection for giving a silly reason of subnormal uterus issue. I have consulted my doctor and he clearly states that for every cesarean operation uterus will be dislocated and it will go back to its position after few weeks. And which will not cause any problem or disease from this in future.

If the reason which you have given causes any further health issues or disease then please give me a clarity and evidence for the same. If not then I am going to knock the door of IRDA and consumer court for diagnosing wrongly or giving wrong information to customers related to their health.

And if you are rejecting my policy with this reason then I need my entire money back with interest for 24 days without deducting a single rupee for test done from your end. As there is no communication or approval before sending us for test that if it rejected then customer has to pay the charges of test. And I have raised a complaint to Max bupa regarding the facility and service which that diagnostics center has given to us.
If you deduct a single rupee then i am going to register a criminal case for cheating in local police station and consumer court for the damages and physical tension which Max Bupa has given to us.

If you can reconsider all this report and issue the policy as committed it will be good for both the parties or if you want me to go legal for the wrong information and report then I am happy to go for further proceedings.

Waiting for your positive reply.

Dear Amit,

This is to bring to your notice that the specified problem which you have mentioned subnormal uterus issue. I have consulted my doctor and he clearly states that for every cesarean operation uterus will be dislocated and it will go back to its position after few weeks. And which will not cause any problem or disease from this in future.

But I really dont know being educated for this reason the policy has been rejected or give me clear clarity what would be the possibilities of having this problem which will effect her future health or what disease will come for which policy cant be issued. So, I want you to reconsider this application and do the needful.

Dear Amit,

I just want to bring to your notice that I never expected this type of worst service from Max Bupa Health Insurance linked diagnostic centre in mysore.

No one is professional from reception to doctor/Lab technician.
They talk to patients in singular and they don't have basic equipment to measure height and weight of kids.
They make mother to stand on regular weighing machine and wrote wrong measurement and made mother to carry one baby and measure the weight and reduce mothers weight and written babies weight. Where we told this readings which you have written is wrong as we have taken mother and 2 kids to pediatrician 3 days before and when they did height and weight measurement of kids and mother where mother was wrong 68kg and this people have written 72kg and for twin 2(Boy baby) it was weighing 3.2kg this people have written 2.4kg. Immediately we approached them and told reading which you have written is wrong. They told this is how we do for all and insurance purpose. If you are not ok then come tomorrow will see. For now we will do like this and that person who was doing scanning was shouting tell me fast i need to go to some function otherwise come after 2 days an in rush.We were never expected this from Max Bupa Health Insurance to send us to this type of worst diagnostic centre in mysore.
Supporting documents is attached which is the report of pediatrician.
We were supposed to come back but once again I can't travel from Bangalore to take them for test as she alone can't take 2 kids for tests as everyone in my in-laws house go for work. So, with lot of difficulty waited for 5 hours with this little kids to finish this tests. We reached diagnostic centre at 9am and came back at 2.15pm.
Please look into it as very serious issue and request you to take necessary action and if it repeats no customer would like to buy insurance from Max Bupa Health Insurance. I am also thinking of cancelling the insurance because of all the bad experience and the time you are taking to issue the insurance. Once again I request you not to tell us to go for other diagnostic centre or wait for policy. If it will take time then please cancel the policy and do the refund and do the needful.

Proposal Number :
5103298
Applicant Name :
Baby of Nandini k
Insurance Company :
Max Bupa Health Insurance
Test Date :
20/05/2018

Claim no: 334343
Policy number – 30437797

Brief – my wife (Patient) during a routine blood test was shocked to see count of 24000 (Where in it should be minimum 150000 to 400000 in a normal condition. We immediately rushed to emergency (Fortis gurgaon hospital) for treatment & it was diagnosed itp (Idiopathic thrombocytopenic purpura) & later it was paid by max bupa.

After a day or two, the count dropped to the same level, again some treatment for itp & paid for second time too!

A week later she again started feeling a low count therefore looking at the urge of emergency, admitted to sir ganga ram hospital & she was given the same treatment to boost the count but this time for the same diagnosis same treatment we were said no!

I have been in discussion with the max bupa team related to my rejected claim which has now been denied twice (Cashless & reimbursement), wherein for the same diagnosis (Itp) it was paid twice in past 1 or 2 months, how come? No one answered why, just denied? They are challenging the diagnosis?

Dr. Nitin gupta have clearly mentioned on the diagnosis about the disorder.in our case itp is idiopathic’ it’s not ‘immune’ (Stamped) both in fortis & sir ganga ram the diagnosis was same than how come it is rejected by their doctors (Who have not even seen the patient) made a declaration that it’s an ‘immune disorder’?

Reason of rejection 'immune disorder'. Please see attached diagnosis & let me know if you are challenging the doctor’s statement that it's immune but not idiopathic?

How come my two previous claims were approved when the reason was same itp?

I am extremely disappointed with max bupa giving me false justification & torturing me for that matter. They have started playing with words & clauses. My only say is how come you say no to what you have already paid for? It’s just that they don’t want pay for what are committed for, simple!

Nitin k. Dhureja
[protected]

I have been with max bupa for last 10 years. Every year there has been some increase in premium, which the company one way or the other could justify.

But this year[protected] there has been an increase of 39% in the premium.

When i asked them i was told that the company has enhanced/added some features to the policy which calls for enhanced premium. Most of the changes do not effect my cover and i would have not opted for them even if they were offered to me free of cost. They are just being dumped on to me and i am being asked to pay for some thing which i do not want.

In all fair business like practices they should have asked the clients if they wish to purchase these additional benefits and they could have been sold to the desired customers at a price.

For me, if they do not change the rules, definitely i am going to part company with them.

Any alternative suggestions...???

I bought max bupa goactive plan from policy bazaar. When for first time i wanted to avail the service to understand the procedure for taking opd consultation service, i called the toll free number of max bupa where although waiting for 10 min i was not connected to the executive. Then i took the help of online chat of max bupa, told my issue, they forwarded my number to an agent of the max bupa, that person told me that since i have not bought the policy directly from the max bupa, he won't be able to help me properly so i need to cancel my policy and directly purchase it from company which will cost me rs 2000 more. This does not make sense to me, so i called policybazaar to help me in availing the opd service, i asked the executive to directly connect me to the max bupa team of the policybazaar, she said that i need to tell her the issue first and then only she can connect if needed. I told that max bupa team will better know the details and will be able to help me but she insisted on telling the issue to her first, i told her about my opd service and the agent who asked me to cancel the policy, she told me to send an official mail regarding this.
So at the end, my purpose of fixing an appointed for opd consultation, understanding the reimbursement procedure was not fulfilled by both max bupa and policybazaar, and this whole thing wasted more than 2 hours of my time.
This is the hassle i faced only for getting opd, what will happen if i was in an emergency situation, will i oscillate between max bupa and policybazaar!!! And why i have to pay more rs 2000 if i buy the policy directly from the max bupa. How come the max bupa website connected me to such an agent who was sitting in karolbagh (Delhi) and advising me to cancel the policy and pay more rs 2000. I was not even sure if he was telling the truth or not.
I have asked the policy bazaar to cancel my policy for which they will deduct 25%, in spite of this deduction i want to cancel it. I am not opting for max bupa anymore and not for policybazaar.

There is even delay in processing my cancellation request.

Hi team,

I wish to log a complaint against max bupa company which is canceling my health policy ([protected]) arbitrarily. I have been a victim of slight miscommunication with the doctor and insolence of max bupa company.

My mother had undergone a minor procedure of hysteroscopy and implanting marine by doctor rooma sinha from apollo jubilee hills, hyderabad. Previously we had consulted with doctor varalaxmi from rainbow hospitals madhapur, hyderabad who had suggested us to go for hysterectomy and pelvic floor repair, which we anyway did not go ahead with.
1. Hysterectomy - due to # bleeding on and off since last 3 years.
2. Pelvic floor repair - due to endometrial mass since 10 years (Which she mistook for '2 years' due to language issues). My mother being a hindi spoken lady and doctor being an english/telgu background, having no common comfortable language.

When i applied for pre-auth request for my mother's procedure from apollo jubilee hills, being a responsible customer i submitted all (Even the previous consultation, although i needed not to) the consultations to max bupa transparently. But i believe there is no value of transparency in the insurance sector, as the claim was rejected. Further, they also canceled my policy quoting clause 3: cancellation by us: you or any insured person has not disclosed the material facts or misrepresented in relation to the policy. They even tried (In writing) relating the # bleeding with endometrial mass which is technical wrong quoting the following, because of which i have a doubt on their team of doctors:
"it has been observed that the patient is known case of endometrial mass since 10 years and bleeding per # on & off since 3 years is a complication of endometrial mass, which falls prior to policy inception date with max bupa."

I have been paying my premiums on time and never claimed a single rupee since inception (Last 4 years). I wish interference from irda to direct max bupa to revoke their decision of canceling the policy since it put the insured at a high risk despite of paying all the premiums and restore the trust in insurance sector.

Insurance details as follows:
Company - max bupa
Product - heartbeat silver 3l 2a
Policy number - [protected] (Running the fourth year)
Sum insured - rs. 3 lakh
Insured persons - shailendra gupta 58 years and rashmi gupta 53 years.
No claims till date since its initial inception (28/02/2015).
Pre-auth claim number - 183808

I have the following scanned copies for your reference, but not able to attach kindly share an email id where i can attach and share with you:

1. 01_maxbupa_policypapers. Pdf - policy papers
2. 02_rainbowhospital_previousconsultation_page12. Pdf - doctor's statement which created concern. At page 12 "c/o mass per # x 10 years".
3. 03_maxbupa_claimdenial. Pdf - pre-auth denial document from max bupa.
4. 04_maxbupa_grievancecommunication. Pdf - grievance communication with max bupa
5. 05_maxbupa_policycancellationnotice. Pdf - policy cancellation notice from max bupa.
6. 06_rainbowhospital_explaination_damagecontrol. Pdf - doctor (Same doctor for point#2) wrote this note for damage control now. I am sending this to max bupa today.
7. 07_rashmigupta_affidavit. Pdf - the affidavit provided to the max bupa company where we have declared that there was a miscommunication due to the language issue.
8. 08_maxbupa_furthergrievancecommunication. Pdf - latest communication with grievance department with affidavit.

Max bupa service request 2349475

I had asked for a super top up policy, as i already have a corporate base policy. I had specifically asked for a policy with no co payment.
Kasturi saha (Sales agent) had explained me charts with deductible and spoke only about super top up policy only. But i got a policy with 'co payment' added in it and it is not even a super top policy, it is a regular health insurance policy with premium of 11500 inr approx.
I have even cross checked with yashwant (Another sales agent) and he agrees that kasturi has sold me a wrong policy (And that could be due to her lack of knowledge). She sold me heart beat individual plan as super top up policy.
It's not about money anymore but lack of integrity which is scary.

I have not got any reply from their grievance team.

Make fake committments with the customers at the time of buying of policy after that all the statements have been changed. Without having any valid reason they denied for my cashless treatment even my family applied at the same time of the admission in the hospital. I was the 5-6 days old fever and cough problem due to that i had some infection in my lung and admitted for the further treatment. Doctors and hospital said the same thing but still they denied for cashless.
No need to go with this health insurance company they are totally fraud and eats customers money and making fool to everyone without any strong reason. Change your health insurance company as soon as possible because with this maxbupa u will also face the same problem. No need to faith on these people.

From :

Sanjay Madhusudan Shah,
4, Gangotri Soc. Near Tagornagar, Old Padra Road,
Vadodara – 390 007
Gujarat

Date : August’17

To
Shri Ashish Mehrotra, Managing Director & CEO,
Max Bupa Health Insurance Co. Ltd., Corporate Office, Block B1/1-2,
Mohan Co-operative Industrial Estate, Mathura Road,
New Delhi – 110 044

Sub:- Notice of cancellation of Policy No.[protected] v ide your letter dtd.14.08.2017.

Sir,

In above matter I had chosen Max Bupa Health Insurance for myself and my spouse as I was given a picture wherein the health insurance facility provided by the company was of best quality and accordingly I & my spouse got insured for a sum of Rs.5, 00, 000/ -. The premium towards the said insured amount is Rs. 18, 552/- at the relevant time. At no point of time during filling of the form, was asked to get medical check up of self and spouse.

It is with regret to note that my claim of Rs.29, 444/- has been straight away repudiated by you on the basis that I had not disclosed of having past history o[censored]lcerative colitis since last
4 months at the time of taking policy. This is absolutely incorrect. If it all you have iota of doubt about my illness you could have asked the treating doctor directly before repudiating
my claim. Further, I have not acted dishonestly or fraudulently nor have I hidden material facts or misrepresented with regards to the policy and as such you cannot terminate the on
going policy during the policy period.

In view of above, you are requested to either reimburse me claim of Rs.29, 444/- at the earliest OR refund me my premium of Rs.18, 522/- and terminate the policy or else I will be compelled to lodge complaint in Consumer Grievance Forum OR take up the issue with Insurance Regulatory and Development Authority of India (IRDA) who resolve disputes and complaints of the aggrieved insured u/s 114(1) of Insurance Act, 1938 fr amed “Redressalof Public Grievances Rules, 1998”.

Hoping for an amicable early solution from your end. Thanking you,
Yours faithfully,

( SANJAY M. SHAH )

We ( family of 3 Husband, wife, child) have an insurance policy from Max Bupa- Heart Beat Policy. We went in for this policy in 2013, wherein the sales representative did a very good job of gaining our confidence!!
Assuming that Health insurances was the best way forward for securing my families health, We chose Maxbupa, . My husband is diabetic for over 15 yrs and hence felt the need we need tohave an Health insurance, which was disclosed to the company at the very beginning.
Since 2013, my insurance premiums have been sky rocketing, from INR 26503/- to 41075/- in the past 5 years( without any claim so far). Logic dictates that at the time of my retirement, I would be paying close to 2 lakhs as premium ( in the next 10-15yrs)
Reasons given via email by the Assistant Manager-Grievance Redressal states
a) IRDA policy b) Inflation cost c) Increase in age.( Did the insurance company think we would get younger in age, defying the nature laws).
I WOULD NOT RECOMEND " MAXBUPA" TO MY WORST OF ENEMIES
IT'S A MONEY MAKING RACKET AND LOOTING IT'S CUSTOMER.

Hello,

I have taken max bupa health insurance policy in feb 2016. My customer id is [protected].in the first year, my total premium for familyfirst gold (1 lac + 5 lac) in which my wife and myself were covered was rs. 15, 518.in the second year i made a premium payment of rs. 15, 657 for the same cover. Now, next month my policy is up for renewal. To my shock, they have increased my due premium to rs. 18, 511.

On being asked about the reasons for such a steep increase, i was informed that my policy has been automatically upgraded which requires me to pay a higher premium. My complaint is that i was never contacted about this upgrade. A nominal increase in premium is understandable but such a steep increase is incorrect. I do not want the associated benefits that the company claims to provide with the upgraded version. I am not ready to pay that extra cost. Why is it being enforced upon me?

I hope for a reply from you and a positive redressal to my grievance.

I have a health insurance with max bupa and the agent name is ravi arora.
But the agent and company share my contact details to some 3rd party and they are calling me and sending emails to buy new policy and renewal of my old policy.
When i asked the agent about this, he said he gives my details to some other members who can do the follow up with me... He is so careless in his attitude regards to customer data secrecy. He also mentioned that i am working like this for past 10 years and i have never seen any rule for this customer data secrecy.
I raised the issue with max bupa and they didn't provide any resolution.
Customer data secrecy is not maintained by the company nor by their agent.
Request to take strict action.

Last year i took maxbupa policy for my parents with approx 35k of premium.
That time they had told me that next year renewable will be approx rs 500-600 more.

Now they are asking me to pay 44k to renew the policy.

Multiple times i have told me to provide a breakup for the rise of premium with such a huge amount.

Beware of this company they are fraud once you are in there trap they will loot you
Dont go with them, better to go with some govt owned policy at least they will not do such fraud.

I regret my decision to go with this company

My son was hospitilised at kpc medical college and hospital and on the first day we produced mediclaim policy no. 4331083 and yesterday doctor advised for relieving and immediately the same was brought to the notice of all concerned.

Till now hospital authorities is not relieving on the plea that confirmation of mediclaim authorities is not received by us.

It is highly intolerable for us and such like of acts is very much harmful for a customer.

Regards,

(A bhattacharya)

If you want to secure the health of your family then never ever take any health policy from max bupa health insurance.
You know why our country is still developing? Because british might have left the country but they are still looting us through companies like max bupa. But the sad part is there is no one who will listen to you...
Words you will hear when taking the claim:
A.) fraud
B.) pre-existing disease which you didn't declare
C.) room out of your policy
D.) fake documents
My case:
Admitted to the hospital: dec 2015
Applied for reimbursement: jan 2016
Claim rejected: feb/mar 2016
Claim rejection reason: fake documents
Policy renewal: end of mar 2016 (Otherwise they wont settle)
Admitted hospital: jun 2016
Cashless approval: day of admission
Cashless rejection: day of discharge
Applied for reimbursement: jun/jul 2016
Claim rejected: sep 2016
Claim rejection reason: pre-existing disease
Policy renewal: end of mar 2017