[Resolved]  Max Bupa Health Insurance Company — Claim Rejected on filmy reason claim id 136726

Address:

Anand, Gujarat

Myself Suchit B Shah had taken Max Bupa Health Heart Beat Silver plan for Rs. 3 lac vide Policy No [protected] dated 05/01/2015. I was admitted to hospital at Anand (Gujarat) for treatment of Malaria for a period of 12.05.2015 to 20.5.2015. Intimation of hospitalization was given to Max Bupa Toll Free No & Claim intimation No 1289343 & claim ID 136726 was generated.. I had submitted claim for Rs. 37773 alongwith required supporting & Discharge summery etc to Max Bupa Baroda Branch on 13th June 2015. On 03rd July 2015, To my grate surprise, I came to know from my advisor that my claim has been rejected citing reason of discrepancies in claim paper/ forged document by Max Bupa. After hearing this I was shocked. I came to understand that Investigator appointed by Max Bupa had given false report that there is discrepancy in patient name mentioned in 2 medical bills claimed is not matching with bill book with medical stores shopkeeper. Hence, Investigator of Max Bupa assumed that entire claim is fabricated & hence liable to reject.. What a filmy & Silly reason to reject a genuine claim. I had personally visited medical stores to verify this & observed that medical stores maintain two bill books for raising CASH MEMO. Bilsl from bill book 1 having large (full Page) is used incase billing items are more & bill book no 2 small is used in case of billing items are less. Investigator checked only bill book one in which he could not find my name on 2 bills. He didn’t even bother to check the bill book No2 & reported Fraud claim?? I had taken the photograph of bills from Bill Book No2 & submitted the same to Max Bupa health insurance Baroda Branch. I had also requested them to reopen the claim on account of documentary proof provided by me. But till date I have not received any further communication from Max Bupa in this regards… I feel cheated by max bupa as I becomes victim of malpractices of Max Bupa. I really wanted to re review my case and hope to get some positive response from Max Bupa side. Looking forward for a sensible reply this time from a senior executive from Max Bupa. With regards Suchit B Shah M.[protected], [protected]@gmail.com