ICICI Lombard
Mediclaim

Dear Sir/Madam,

I have sent three claim documents dated 09/05/08 for medical calim to Ms. Vibha, Insurance Help Desk Kalina Office. Mumbai, but one of my claim of dental surgery was returned due to not covered under the Lupin's Mediclaim Policy and two claims CCN 1325868, 1325910 has been forwarded to the insurance company.

I received the deficiencies letter for CCN 1325910 on dated 23/05/08 and CCN 1325868 on dated 27/05/09.

And sent a mail to mediclaim on Dated 29/05/08

Dear Madam,

With reference to your mail dated 27/05/08 and 29/05/08 regarding mediclaim CCN 1325868 and CCN 1325910, I have already submitted all the original documents where date of admission, date of discharge, sign and symptoms, investigation, diagnosis, treatment required and payment are mentioned. I do not have other documents to provide.

I strongly request you to kindly process my both applications with the documents already provided.

Thanks with regards,

In this connection I got a reply from Insurance Help Desk on 17/06/08

Dear Sir,

As per your pervious mail that you can not submit the deficiency documents for you 2 mediclaims so kindly get the letter from the hospital that as per the deficiency for

1st hospitalization

let them mention about all the deficiency like what was the Diagnosis

how much amt received (Payment receipt)

1) Original Discharge Card Of Kailash Jain Hospital With Details Of Presenting Complaints, Treatment And Diagnosis Dated 08/03 To 10/03 Required.

2) Original Cash Payment Receipt Of Final Hospital Bill Required.

3) Positive Investigation Report Supporting The Diagnosis Like Blood Sugar Report Required.

4) Item Wise / Cost Wise Detailed Breakup Of Rs.11660/- Charged For Hospital In Final Bill Required.

5) Duly Attested & Paginated Xerox Copies Of Indoor Case Papers Required. DOA8/3/08to10/03/08

2nd hospitalization

as above mention

A Letter From Treating Ophthalmologist Stating The:

A) Presenting Sign & Symptoms Of The Patient On Admission With Duration.

B) Probable Etiology Of The Said Ailment.

C) Details Of Procedure Required.

2) Details Breakup Of Rs.14000/- Required.

DOA06/03/08 to 07/06/08

Or else get the letter from the hospital on Hospital letter head that they are not giving any of the deficiency documents for the both claims then may be insurance co. will consider the case But you try to get the documents from the hospital.

Thanks & Regards,

Vibha Gotpagar

Lupin - HO

TEL: 022 664 02 332

I have sent the letter from hospitals mentioning with they are not giving any of the deficiency documents on dated 21/07/08.

After taking the long long time I received the Repudiation letter of the claim CCN 1325910 on dated 30/12/08.

And one of the claim CCN 1325868 pending with ICICI Lombard.

I request you to please look in to the matter and reimburse both the claim.

Please do the needful.

Thnaks and Regards,

Gajendra