[Resolved] Royal Sundaram General Insurance — denied post hospitalization claim

Ankita Gogia

Address:

Rider House, Plot No : 136, Sector 44, Gurugram, Haryana 122002, New Delhi, Delhi, 110006

I was admitted in hospital on 4th December(Policy No. HSAA[protected] &(Settlement of claim number: IH18004424CSL01) for major abscess surgery which required daily twice dressing and it was not possible to visit hospital daily for dressing because i was on bed ridden and could not walk. So we appointed doctor for daily visit at home which was way too expensive but as i was medically covered, i knew that it will be reimbursed according to the post hospitalization policy . But they denied all the amount of my treatment saying that home visit not allowed. I am attaching the my summary report in doctor have clearly advised for daily twice dressing. How can they deny whole treatment reimbursement . This is so unethical. Why do we take medical policies if we dont get it covered properly. I request you to kindly give me my reimbursement amount otherwise i ll go to consumer court and file a police complaint as well

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Apr 29, 2019

Complaint marked as Resolved

Royal Sundaram General Insurance customer support has been notified about the posted complaint.

Mar 28, 2019

Updated by Ankita Gogia I received an email from royal sundaram stating that according to IRDA guidlines they cant give reimbursement for home visit charges.

But in my previous surgery which happened on 1st august, they reimbursed home visit charges as well. And now they are denying it . Its clear that they are fraud . Its clearly mentioned in the policy that 60 days of post hospitalization will be covered in the policy. Kindly sort this issue out otherwise i will go to the court for mentally harassing me.

Verified Support

Mar 29, 2019

Royal Sundaram General Insurance Customer Care's response Hi Ankita, this is concerning to hear, and we regret the inconvenience caused. We've made a note of your details, and the same has been escalated to our team on priority. Be assured, we'll get back to you with an update at the earliest.

Apr 09, 2019

Updated by Ankita Gogia I am really disappointed by royal sundaram, as i discussed over the email that i got reimbursed for my previous surgery for home visit as well and now they are denying . Even they are not on their words and they do not know their policy rules. Now they are asking me to refund the amount which they settled in my previous surgery . This is clear mental harassment from their end. First of all they deducted my whole treatment amount of Rs 60000 from the reimbursement and now they are asking for refund for previous surgery . They are the No1 Fraud company. Already i am going through financial crisis due to medical problem. And they are mentally harassing me . First they did not pay the reimbursement amount saying that it was home visit charges and now they are asking money from me for my previous surgery they paid. Which genuine company does that . Why do people get themselves insured if they don't get the claim reimbursed.