MediClaim denied by National Insurance Co. Ltd.
To,
The India Consumer Complaint Forum
Subject - Request for Mediclaim Mr. Ashok Mudgil, Mediclaim No. NI-3-139198 A/C under policy No.360901/48/09/8500001325
Dear Sir / Madam,
I had taken health Insurance policy for my whole family which includes me, my wife & two sons from National Insurance Co. Ltd. Bikaji Cama Place, New Delhi, India. I am giving details as under. The National Insurance Co. Ltd. has denied my health Insurance Claim on the pretext that I was late in submitting all the documents related to my treatment, where as I informed the company about my treatment in Jun and submitted all my documents after the my by pass surgery in the month of Oct. They have cheated me financially, physically & mentally. The executives representing the National insurance Co. Ltd. promised us to provide a cashless policy & till today I have never been issued with the Mediclaim ID cards where as my family is covered for this health insurance since last three years. I had been regularly in touch with the office bearers for my claim but all in vain it seems this is a money making racket & once they get the premium for the policy the consumer is made to run from post to pillar. I am forwarding the details of my communication as follows, further I submit that all the original documents related to my surgery & treatment are submitted with the National Insurance Co. Ltd.
I request the Indian Consumer Complaint Forum to help me in seeking justice to get my mediclaim at the earliest.
Thanking you in anticipation
Ashok Mudgal
09958092414
FOLLOWING is the previous communication with the National Insurance Co. Ltd.by me through Email.
&-- Forwarded Message &-
From: ashok mudgil
To: [email protected]; [email protected]
Sent: Sat, February 19 11:23:56 AM
Subject: Fw: Ashok Mudgil-MediClaim No. NI-3-139198 A/C under policy No.360901/48/09/8500001325
URGENT REMINDER
Dear Sir,
It seems you are not so serious about my MediClaim & I am sending you this as my last reminder for immediately processing my MediClaim, else I will approach the consumer court for seeking justice. I have mentioned to you the reasons for delay in submitting the documents & it should be known to you that I was always covered during this period under your MediClaim policy. Further you will have to pay for the learned Advocate's fee for approaching the consumer court.
BRGDS / Ashok Mudgil
&-- Forwarded Message &-
From: ashok mudgil
To: [email protected]; [email protected]; [email protected]
Sent: Tue, February 8 2:10:14 PM
Subject: Ashok Mudgil-MediClaim No. NI-3-139198 A/C under policy No.360901/48/09/8500001325
To,
The Senior Branch Manager,
National Insurance Company Ltd.
Bikaji Branch,
New Delhi.
Dated: 08.02.2011
Sub: Claim intimation of Ashok Mudgil, vide Mediclaim No. 360901/48/09/3500001325
Dear Sir,
This is to inform you that I, Mr. Ashok Mudgil insured with your branch under above mentioned policy under went severe heart treatment in different Hospitals on emergency basis since 04.06.2010. This was intimated to your office on 08.06.2009 for my Mediclaim & issuance of claim form in this regard. On 06.07.2010 I was finally admitted in Madanta (Medicity – Gurgaon) for Heart bypass surgery. The bypass surgery was conducted at Madanta – Medicity on 08.07.2010 & was discharged on 16.07.2010 after being advised by the concerned doctor to have a complete three months bed rest. In the mean time my wife Mrs. Pummy Mudgil also under went HIP Replacement at Orthonova Hospital in Delhi on 23.07.2010. This medical problem concerning both of us delayed in submission of my medical documents related to the above Mediclaim.
Now I request you to kindly do the needful accordingly and reconsider my claim at the earliest, as I have received a letter from your office dated 02.02.2011 mentioning that on the basis of the report submitted to your office by TPA M/S Alankit health care TPA Ltd. my above mentioned claim has been declined as NO-CLAIM.
FYI I have submitted the claim form after taking the help through some one & submitting all original documents related to my heart treatment, surgery & then follow up expenses incurred by me for Mediclaim along with a cancelled cheque of my saving account for your reference & fast processing of the Mediclaim.
Further, I would like to intimate your office that we all family members never got issued with Mediclaim photo ID cards, therefore we request you to issue us the photo ID Mediclaim Cards without any fail.
Please reply to me at the earliest for this Mediclaim request of mine for necessary action.
Thanking you in anticipation.
Regards
Ashok Mudgal 16, Vasant appts. Raotularam Marg, Vasant Vihar, New Delhi –110057
91-9958092414
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