Subject: Non settlement of Medical Claim
Claim of Rs 2, 28, 484.00 towards Mediclaim and harassment
(ESTIMATE FOR BY PASS GIVEN: Rs 2, 84, 000.00)
Ref: Claim NoHH111003544
Policy No.100330/48/08/8500004737/100300
Dear Sir,
This refers to the series of discussions, I had been writing to you on various occasions for clearance of my Medical Claim towards CORONARY ARTERY BYPASS GRAFTING (CABG) SURGERY.
Surprise to read the rejection of my claim and content written their in:
“The reason for such repudiation are as under: clause:4.3 disease excluded in the first two years of insurance”.
It would be judicious to tell you that “CORONARY ARTERY BYPASS GRAFTING (CABG) SURGERY” falls under Mediclaim Insurance Policy Clause No 4.1 instead of 4.3.For ready ref I am here with attaché and enclosed a policy write up clause 4.1 in page no 3 which clearly stated “CORONARY ARTERY BYPASS GRAFTING (CABG) SURGERY” in colum no 2 serial no2.
All my reports, related to my surgery clearly indicate Coronary Artery Disease and Under the Insurance law, The Consumer Protection Act 1986 and Consumer Rights the Remark and comments given in your letter is judicially unfair and not acceptable.
Thus we earnestly request you to co-operate us by settle my claim.
Please look into the matter with all positive possibilities to avoid any legal proceeding.
Your kind cooperation and a favorable action help us to overcome from heavy financial crunch.
Regards,
Thanking You
Rajesh Soni
DGM Intl Marketing
JK Millennium Centre, 6th floor,
JL Nehru Road, Kolkatta WB –700071
Ph (D)-033-30512213
Fax 033-22882565/ 1717
Mo- 919831878738
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