National Insurance Company — Rejected claim

Address:

noida

Dear Sir,

My name is Vipin Kr. Singh s/o Late Mr. Madan Gopal Singh, working with LG Electronics India Pvt. Ltd. I have Family Health Plan Insurance Policy from National Insurance Co. Ltd. from last more than 10 years. My father was Hospitalized from 29thDec 2018 to 20th January 2019 but he couldn’t survive and passed away. I submitted Original copy of Detailed Bill of SGPGI Lucknow, which contained every details ie all deposit amount detail and expenditure against that amount. The insurance company asked for original copy of each cash deposited receipt which was misplaced cozed I was totally disturbed due to my father’s illness. Anyhow I requested to the hospital and they provided duplicate copies of all cash payment receipts and same I provided to insurance company. I received 3 mails for insurance company and in all mails it is mentioned that all documents are pending. I also regular in touch with HR person of my company regarding and he informed me that he has handovered all documents to insurance company and talked also regarding my case but Insurance company is not agree to settle my claim because cash receipts copies are in duplicate form. I spoke to HR person finaly regarding my claim and he assured me that he has submitted it for settlement and will be cleared by the month of July with some approval but I didn’t get it. Insurance company delayed it and didn’t tell me clear picture. In Feb 2020 I got a mail from insurance co. that my claim is regected due to non-submission of proper documents. In Mar 20 when I finally asked the insurance person regarding he told me that now the claim cannot be given as it has already more than 1 year passed. I spoke to PR Deptt. Of PGI Lucknow and they assured me that if Insurance Co. gives a Demand letter and ask for details, they will provide all details of my father’s case but Insurance Company’s person denied it. Now I request you to please intervene in this case and help me to get my claim. It’s a big amount and matters a lot for me. Please help. Details are as below & attaching latest rejection mail from insurance co.

Patient CR No. of SGPGI Lucknow Is : [protected]
Insurer Name : National Insurance Co. Ltd
Hospital Name : Sanjay Gandhi Postgraduate Inst Of Medcal Sciences
Corporate Name : LG Electronics India Pvt Ltd : 00810
Policy Holder Name : Vipin Kumar Singh
Insured Name : Vipin Kumar Singh Policy No: :[protected]
Employee ID : N01115 Relationship : Father
Claim ID : 2294573/1 UHID No: : 621233
Date of Admission : 29 Dec 2018 Date of Discharge : 20 Jan 2019
Claim Type : Reimbursement Claim Amount : Rs. 293138/-
Diagnosis : Post Traumatic C4-5 and C-5-c6 PIVD with C3-6 cord contusion with central cord syndrome with quadriparesis with bowel bladder involvement with left pneumthorax