Max Bupa — MaxBupa, (max bupa) fraud lie and cheat

Address:	New Delhi, Delhi, 522001
Website:	maxbupa.com

Hi Max Bupa Team,

This is with reference to the Claim denial and cancellation of my policy from Max Bupa. Firstly, please return all my original medical documents exactly the way I sent your MaxBupa Delhi Head office address without any writings or stamping on them to my mailing address at the earliest.

Secondly, I do not want any claim from you. I just want the right justice of YOUR SALES AGENT DISCREPANCY, FRAUD, LIE AND FILTH DISHONESTY and refund the premium I paid when purchased the policy. I have no problem you rejecting the claim and cancelling my policy. I just want the right justice as MAXBUPA TO BE BLAMED FOR THEIR SALES AGENT, MR. PANKAJ SINGH GOEL'S DISCREPANCY, FRAUD, MISLEADING INFORMATION GIVEN TO ME WITH LIE AND FILTH DISHONESTY ON 3RD AUGUST 2016.

Now you say Mr. Pankaj Singh Goel resigned from his job and there is no such call recording found on 3rd August 2016 when i had clearly spoke to Mr. Pankaj Singh Goel as I had already informed him about my brain tumour condition on 3rd August 2016. And, your Maxbupa Verification agent Mr. Abdullah (cell phone # [protected]) clearly told me that i had already informed about my brain tumour condition to MaxBupa Toll free Customer Care team on 3rd August 2016. How come he knew about this? Now you say there is no call recording of me conversing with Mr.Pankaj Singh Goel via Maxbupa Toll Free Customer care number!!! This is DISGUSTING!

I am extremely disappointed with Max Bupa giving me the wrong/misleading information with discrepancy after I had spoken to Mr. Pankaj Singh Goel from Customer Care team on 3rd August 2016.

I was told over the phone by Jasleen Kaur that there is no call recording found with Max Bupa Customer Care Sales agent Mr. Pankaj Singh Goel on 3rd or 4th of August 2016. But, (Maxbupa verification agent) Mr. Abdullah (cell phone # [protected]) visited my place and told me I had already informed about my brain tumour, seizures, emergency hospitalization on 3rd August 2016 and he told me they had tracked through my call recording. I already told Abdullah about the same that I had spoken to Max Bupa Customer Care Sales agent Mr. Pankaj Singh Goel on 3rd or 4th of August 2016 and told everything about my existing health condition on 3rd August 2016. Max Bupa is not accounting their blame at all but instead blame the insurer even though there is FAULT and misleading information from Max Bupa's end as well. Now Max Bupa says they have no call recording of Mr. Pakaj Singh Goel and putting entire blame on me.

1). I need the call recording be forwarded to me when i spoke to Mr. Pankaj Singh Goel from the Customer Care Sales Team by calling the Max Bupa Toll Free number in the first week of August 2016. He gave me the wrong information even though I had told him about my brain surgery under emergency hospitalization. He had told me any emergency, life-threatening or accident hospitalization will be covered from DAY ONE from the purchase of Max Bupa Heartbbeat Gold policy and had clearly told me if it is planned hospitalization, there is a 90 day waiting period. You can track the call recordings with me and Mr.Pankaj Singh Goel through mobile numbers [protected], ********, ******** (mentioned in email to maxbupa). If you cannot share that call recording, please provide a valid reason and proof as per IRDA.

You have replied " We would also like to inform you that we have got your claim request number – 215852 reviewed by our panel of doctors basis the details shared by you and it has been observed that the patient is known case of meningioma since 3rd August 2016 ".
I had already informed Mr. Pankaj Singh Goel about this on 3rd August 2016 and I was INSISTED to write my conversation with Mr. Pankaj Singh Goel on a plain white paper by your (Maxbupa verification agent) Mr. Abdullah (cell phone # [protected]) and he told me to sign and had taken my thumb impression.

2). Under Heartbeat Gold Policy, as per the policy document I received from Maxbupa, in Section 4(b), it states " 90 days for illnesses except any accident or emergencies.

You replied " Sir, we request you to kindly go through the emergency definition mentioned in the terms and conditions of the policy document which says “A severe Illness or injury which results in symptoms which occur suddenly and unexpectedly, and requires immediate care by a Medical Practitioner to prevent death or serious long term impairment of the Insured Person’s health”

Please provide a screenshot or proof about " EMERGENCY " definition under Max bupa Heartbeat Gold Policy. I had already mentioned the clauses and sections about " EMERGENCY " under Max bupa Heartbeat Gold Policy from my policy handbook that I had received. Mine was an emergency hospitalization under life-threatening situation on 20th August 2016 and my brother had already intimated to Maxbupa Toll Free Customer Care number on the same day. I already told your your (Maxbupa verification agent) Mr. Abdullah (cell phone # [protected]) it was an emergency hospitalization and told him to verify with the hospital management and my surgeon. Could you prove me as per the policy document that " EMERGENCY " under Section 4(b) will not be covered if it is associated with Section 4(a) under Pre-existing disease?


3). Does it mean, if the insured has pre-existing disease and i[censored]nder " EMERGENCY " been hospitalized within 90 days from the purchase of the Heartbest Gold policy, then insured claim will be denied considering it as Pre-existing disease even though it is an " EMERGENCY " hospitalization for the insured?

4). Your (Max bupa) verification agent Mr. Abdullah with cell phone number: [protected] had visited my place and told me that under Section 4(a) Emergency means ONLY CARDIAC related. Does he even know what does " EMERGENCY " means as per Maxbupa Heartbeat Gold Policy?

I request you to respond correctly as per my questionnaire in the same pattern and number series. If you are unable to reach my number [protected], please provide me with your number so that I call you back or email me.

You replied " we would like to inform you that we have done necessary verifications at our end and we have not observed any discrepancy in the sales process followed while sourcing and processing the said policy."

I need the above mentioned information at the earliest as I was given misleading and wrong information by Mr.Pankaj Singh Goel from your Customer care team toll free. There is a discrepancy, misleading information considering my conversation with Mr.Pankaj Singh Goel on 3rd August 2016.

My Policy number is [protected], Customer ID: [protected]
Claim number: 215852 and PDF is attached for the same.

Regards,
Riazuddin Mohammed
Ph# [protected]