Religare Enterprises — unfair/cheat from religare health insurance

Address: 560046

Website: www.religarehealthinsurance.com

Hi,

My wife chandani get admitted to the hospital (Msrmh) on 29th aug 18. She had lscs. I informed to babu and bharat regarding same before she had lscs and the cashless treatment started from same day.

The hospital sent pre-auth to the religare with the estimated cost of 68k and initially they (Religare) approved 50k (Without raising any concern on opted service) in order to start the treatment. Please find the same pre-auth in the attachment named pre-auth. Pdf

In the pre-auth they have clearly mentioned that it is a package for lscs of amount 60k and no where they have mentioned only the bed charge as 6200 which religare is claiming to have. Please refer the pre-auth. Pdf in the attachment for more details which states that the amount inr 6400 comprises doctor’s fee, investigation charges etc and not only the bed charge. Again which comes under package of lscs.

I requested the hospital for the final discharge summary and i am including the same with this email named dischargesummary. Pdf

I have below question which need to be clearified.

Please refer the dischargesummary. Pdf in the attachment and clarify that how come you have deducted the further amount which were initially approved from you, leave about the approval of remaining amount (60k – 50k = 10k).

Incase you were assuming that the patient had opted for higher service and the estimated bill sent from hospital in the pre-auth is 68k then how come you approved 50k initially, it should not be more than ~25k? Which again mis leaded us that approval of bill is almost complete from religare side.

If you were mis-interpreted the pre-auth (And assumed that i opted for the higher service) then how come you have not raised your concern that time and instead approved 50k? That means you were waiting for the moment/opportunity so that you (Religare) can pay the bill as less as possible.

As per my understanding and so far experience with religare, it clearly shows that first you tried to mislead us by approving the random amount (50k) against the estimated bill (68k) and then tried for the minimal possible pay-out by making excuses that patient has opted the higher service.

After hearing lot of negatives from the policy holder’s of religare (Like religare will always give you excuses and create some drama when it comes to pay the genuine bill, so that they (Religare) will pay the minimal possible bill), i use to contact 2 times a day (During my wife’s hospitalization) to the religare customer support team over phone call to know the status and none of your executive informed me about your assumption/belief that i opted the higher service, instead they use to assured me that you will get your whole amount i. E. 60k in this case. Please check this record/fact and verify. Who is responsible incase your customer support team is sharing wrong info.

Please let me know your intensions regarding paying the genuine bill amount (60k) so that i can refund your ~28k as well incase religare is not intended to pay genuine bills.

Thanks
Ranjan