National Insurance Company — Health claim claim no. 22786894 P.no.[protected]

mukeshmehta013

from Pune, Maharashtra

Jan 11, 2022

Address:

11 M. G. Road, Camp Pune 411001

I Mukesh Mehta had claimed vide CCN no. 22786894 under policy no.[protected] of National Insurance Co. Ltd. National Mediclaim Policy. I have a policy of Rs. 5 lacs and submitted a claim of Rs. 192316/- on 16/09/2020. National has sanctioned only Rs. 94560/-.
The status on 24/11/2020 on their their Medibuddy website was showing approved amount as Rs. 159373/- but on final sanction they only sanctioned Rs. 94560/-
We had given many reminder mails for the complaint to be resolved but they replied us for the same as compliant status closed after almost 8-9 months.
I have already submitted a complaint in ombudsman. Received a mail on 10/08/2021 that the grievience has been closed saying that claim has been settled as per Maharashtra State Govt guidelines.
I have taken a policy that also with a sum insured of Rs. 5 lacs for no financial loss in an emergency, but the basic purpose of me taking the policy is not fulfilled, insurance company should pay the claim as per their policy terms and conditions and not maharashtra state govt rules, as we were not informed that claims will be paid according to maharashtra government rules.

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National Insurance Company customer support has been notified about the posted complaint.

Mar 08, 2022

Updated by mukeshmehta013 There is no action taken since last 55 days about my complaint, kindly look into the case and ask National to resolve my complain and pay the balance amount.