[Resolved]  Religare Health Insurance — Cashless claim deny just giving stupid excuse

Address:

131001

Complaint Details: Your Name: Rakesh Chhikara Your E-Mail:chhikara.[protected]@gmail.com Your Contact No. [protected] Your City: Sonepat Complaint Against: Religare health insurance Complaint Category: Doctors & Hospitals Claim Amount (Approx.): 15000 to 20000 Subject: Cashless claim deny just giving stupid excuse Your Complaint Description: I have taken a family health plan Policy number 52106200 of 5 lacs before 6-7 months ago. I got an minor accident on 12th December night because of slipping my scooty front tyre and I fall towards left side all weight on my shoulder. At night I take a pain killer n slept. Next morning I feel huge pain in my shoulder n in my head. One of my friend went to hospital n referred name for emergency in Cygnus J K Hindu Sonepat. I go their they told me to deposit Rs. 10000/- at counter. I show them my religare card but they told me that today is Sunday n our TPA section's holiday n tomorrow in the evening will refund my money after approval from religare. They make an X Ray of my shoulder n CT Scan of my brain given me some pain killers n admitted in emergency. As report found n fracture in my shoulders bone n CT scan reports are OK. They shifted me in private room n start treating. I tell to doctor that once 7-8 years before I was felt from m.cycle n got fracture in my shoulder that time. I m hospitalized right now but religare deny my claim that I have to produce the hospital documents of 8 years before that how I got the fracture another they had rejected my claim. N please also tell me once when I was 6 years old I got a fracture in my right leg if in accident I got fractured in my right leg I have to produce 29 years ago hospital documents as I am 35 years old now . Doctors has clearly certified that this is fresh trauma from accident and a representative of religare also comes in evening taken my written statement with my injured shoulder photographs with my photo ID but even now they are making excuses.Should I file case in consumer court?