ICICI Lombard Medical Insurance
Non settlement of my medical claim

I was insured for the ICICI Lombard health care scheme which is valid up to 24th feb . (policy no : 4034/fpp/03294458/00/000, Card no: IHPN-03444390/01)

During the insured period I fell down at the toilet and was admitted to a hospital listed in your handbook (MIMS – calicut). At the time of insuring I was told that this is cashless treatment option and no need to pay any cash upto 3 lkhs. Also the executive told that I will be paid Rs.1000/- per day at hospital (ref. the tele conversation recorded at your office )! But at the hospital they didn’t allowed for cashless treatment!

I paid all my hospital bills from my pocket and I sent the bills to your claims settlement department – TTK! The total claim amount was only Rs.5057.00 1000x2 for 2 days at hospital (which was told, will credit to my icici account). My hospitalization was a genuine case and I submitted all documents as instructed but still I was only paid Rs. 2607/- initially. Again I communicated with TTK health care and then they settled Rs.2165/- as second part! still I lost Rs.285/- agreed 1000/- for 2 days ie Rs.-

The reasons informed me for not allowing Rs.285/- was that hospital registration charges are not payable and No lab reports for some amounts! as you know normally a patient will pay registration charges in hospital only when he /she is admitted there to take treatment and not for attending any party or star show at hospital!!! Also the full lab report was submitted from my side which I am ready to prove at any extend!! (refer the copies of letters & documents of earlier correspondence with Ttk, attached here with for your kind reference)

My total loss in this case was Rs.2285/- I have approached TTK directly for settlement without the help of any agents! I think that is the reason for loosing money for me!!! Bcos I can see people getting claim amounts without any issues if submitted with the help of insurance agents!

So now please let me Know that, if you were at my place, will you renew your ICICI Lombard policy further to one more year? Will you recommend this company to your friends?

i can prove all above said information with solid supporting docs

sheen, 09349138146

Company: ICICI Lombard Medical Insurance
Country: India

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