Sir/Madam,
I am writing this to complain about my frustrating experience with “ICICI LOMBARD”.
Reference is made to my "ICICI LOMBARD" health insurance policy bearing No. 4034/FPS/02375300/00/000. This policy described above was sold to me (by the virtue of holding ICICI credit card) on 07/07 through a tele sales executive and was briefed about the yearly premium, extent of claims and the only exclusions (dental & cosmetic surgery) for which the expenses would not be reimbursed. Going by the reputation of ICICI, I had decided to purchase myself an insurance cover and the payment for the same was promptly collected by ICICI from my credit card.
At no point of time had ICICI provided me with the terms and conditions/ contract/ exclusions list and neither did I ever happen to sign any document acknowledging the understanding of the terms and conditions.
After more than 20 months of purchasing the insurance cover, unfortunately I was diagonised for kidney stones by “Chinmaya Mission Hospital” Bangalore and was suggested by Dr. Ninan Thomas for a surgery as it was inevitable and most needed. Reacting to the Doctor's advice, I had contacted ICICI on xx/xx to accord their approval for the surgery on cashless basis. TTK (ICICI) promptly responded to my request based on the reports by Doctor and faxed me a copy saying: "The particular hospital is not a part of the panel and hence I may pay the hospital bills and apply for reimbursement."
Going by the instructions thus received, I applied for the reimbursement after completion of surgery by providing necessary reports and bills. On applying for reimbursement I was shell shocked to hear rejection of my claims from ICICI/TTK based on the reason that my ailment is not covered under insurance as per clause 3.3 which was neither provided to me in any form nor was I ever briefed.
Now, I strongly feel this has been a deliberate attempt to cheat and victimise me by ICICI LOMBARD. ICICI LOMBARD has not disclosed/misrepresented and mislead me with the information and clauses with affirmative implicit & malicious intentions.
I strongly insist ICICI to provide me with a copy of my acknowledgement towards acceptance of the terms and conditions/clauses or an audio file of my verbal acceptance of the same. In the event of ICICI LOMBARD being unable to provide either of the above, I demand for a quick reimbursement of my claims with no further harassments.
I would highly appreciate your intervention in reimbursing my claims. I look forward to your reply and resolution to my problem.
Best Regards
Y.M. Joseph Mathew.
0 comments