Max Bupa — MaX Bupa Unethical business practices to harassment of customers

Address:

Pune, Maharashtra

Dear Manager, Max Bupa I am just recovering from a large surgery, but due to Max Bupa irresponsible behavior and unethical practices to reject any claim No 57074, I should raise my voice and show you facts that this is a proper unethical rejection done by Max Bupa.I know these insurance companies have 1000 reasons to reject claim and they only make money on rejecting and selling. FYI I am taking this matter to consumer court with mental harassment also. FYI…First symptoms and diagnostic of GERD happened after inception of the policy and I have complete documents with doctor’s certificate. They just rejected the claim as some junior doctor has written in my IPD document 3 To 4 Years instead of 3 years. Anyway I have my treating doctor’s certificate attached and Max Bupa should reconsider my case. First time diagnosis of my hernia covered by Max Bupa please find below details -: Member Reimbursement Statement Dear Mr. SINGH, We refer to your claim for reimbursement of eligible medical expenses for your hospitalization as detailed under. We wish to inform you that your claim has been approved for settlement. If any deductions have been applied to your claim, please find appended details of such deductions. Claimant name : CHARANPAL SINGH Customer ID : [protected] Diagnosis : Other specified abdominal hernia with gangrene Claim number : 3718 Date of Admission : 18/10/2011 Date of Claim Receipt : 02/11/2011 Claim Amount :Rs. 7, 625.00 Applicable Co-Pay :Rs. 0.00 Shortfall Amount :Rs. 155.00 Settlement Amount :Rs. 7, 470.00 Total shortfall amount is INR 155.00 as described below: Shortfall amount Service Type Reject description Rs. 155.00 Accommodation non payable items I was suffering from a problem Hiatus hernia and 1st time got diagnostic by an endoscopy after inception of my max bupa policy number – [protected]. 1st identified – 18/10/11 claim Number 3718 -with an endoscopy of course this disease not comes in pre existing clause at all. And maxbupa reimbursed the complete amount of 1st diagnostic without any issues. Now treatment started I was on medicine from past two years, and my doctor has suggested me a surgery I have taken an approval of a planned surgery pre-authorization 57074, I got accordingly started process done all the arrangement. At the day of discharge I got a rejection message from Max Bupa suddenly they identified that this disease comes under preexisting and coincidently Max bupa has covered my first identification of the same disease with any problem. I have not Hided anything from Max Bupa which cleared in the attached doctors certificate as my problem got diagnosed after purchase of policy Max Bupa have no rights to reject my claim in any circumstances. Suddenly I arranged Rs 1, 14, 000 to pay my hospital bill tonight it was totally harassment and in this condition I have taken lots of tension. I will fight for it now weather you refund my money or not I will tell with the help of media and putting a case in consumer court so that consumer think 1000 times before dealing with Max Bupa. Regards, Charan Pal Singh [protected]