Max Bupa — Claim Denied without proper investigation and proper reason intimation

Hi Team,

I was hospitalized on 28th Sep 2020 till 30 Sep 2020. As that was a peak time of COVID-19, I have joined in the hospital where we don't have much facilities such as corporate hospitals.
I have raised a Reimbursement Claim number: [protected] in the month of November.

From the month of November 2020 to till February 2021 max Bupa was simply dragged my claim application by asking "Hospital Final Bill". Even after submitting the the Final bill also, they were asking the same again and again.
I was called to the customer care center so many times by paying minute to minute, none of the executive have full information, even then I have requested them to arrange a call back with the claim department to explain my problem and understand their requirement, but out of these many months of time not even a single call received from them on this issue. I understood that they are not willing to resolve the issue and reimburse the claim.
As i already pointed, it is a remote hospital, where diagnostic centers and medical shops are not in the same premises and all are individuals bodies. I have taken the bills from each of them and surrendered to the Max Bupa team, still there is no response.

I have raised so many complaints with the customer care, but no one is considering and not even calling to the customer and seeking for the details to resolve the issue. No way. Except during the policy time never ever received a call from them.

Here one surprising point, My policy is Group Policy which means via HDFC they have provided this policy, after i raise this request only got to that, there is a differential treatment among the direct policy holder and group policy holder.

Being a group policy holder, i can not access any mobile app applications or cannot raise any claims. Anything we need to do it on our own. I don't know these complications and all while taking the policy.

With the health policy I used HDFC, India Insurance etc.. with these I did not faced any issues. They and their response is quite good, they will give the detailed explanation for rejecting our claim. If it is valid we also ready to accept.
Where as here with Max Bupa, got a single line statement as below

"We regret to inform you that claim ID [protected] of NALLAPUDI KUMAR has been denied for settlement based on the terms and conditions of your policy with us. We apologize for the inconvenience caused due to this. Please find attached a summary of the claim details for your reference."

Here my doubt is on what basis, which condition/term based you declined, not information.

Very Worst experience I have with Max Bupa.

Thanks,
Pavan Kumar N.