[Resolved]  Religare Enterprises — Unprofessional and fraudster

To,

The Care Health Insurance

Date: 22/10/2021

Subject: Claim amount for re-imbursement

Sir/mam,

With due respect, my name is Manish Kumar client of RBL bank and Care Health Insurance Group Policy No: 18016595, Certificate of insurance no: 31820758. My wife Alayka Mackerdhuj Juggan-Aheer into Mata Chanan Devi Hospital on 16-Oct-2021 for vomiting, stomach pain, loose motion. Before she went to OPD for consultation on 06-Oct-2021, Dr. gave her medications for relief but stomach pain, vomiting, loose motion still continued while on medication. She went to OPD again for Dr. consultation on 13-Oct-2021 but pain still continued. Finally the Doctor suggested her to get admitted into the hospital on 16-Oct-2021 at Mata Chanan Devi Hospital. The doctor’s concern was why my wife had gotten so dehydrated as he feared that she could have died from dehydration due to the excessive vomiting. On the 19-Oct-2021 I received a call from a care health insurance representative regarding an inspection for my wife treatment and that he was coming for an inspection in the afternoon at Mata Chanan Devi Hospital. He came for an inspection and was asking questions while my wife was vomiting. I would like to mention one thing about the representative, he had very unprofessional manners. The representative’s exact words were and I quote, “You will get your ‘APPROVAL’ in an half an hour or latest one hour time”. On the same day in the evening the denial letter came through from care health insurance and the reason was “Non-disclosure of material facts/pre-existing ailments at the time of proposal- Anaemia. The representative questioned my wife if she was aware of being anaemic before and my wife replied with truth that she had anaemia in 2012 but was fully cured in 2014. She explained everything about her cure and I think the representative made a mistake as he might have forgotten to write that the ailment was completely cured. In the evening of the same day a rejection letter came. If my wife wanted to lie that she never had anaemia just foe the claim she could have done so by saying that she never had anaemia before. I thing it would have been better for us to lie and get the claim amount approved but we didn’t do that. Even when we speak the truth our claims still get rejected. Do you know how frustrating and disappointing it is for us to get a denial when we have insurance policy in the time of emergency. If I had to pay cash for treatments then why did I take the insurance policy. My wife and I were not asked about the pre-existing disease at the time that the policy was taken. Totally the fault of insurance company and RBL bank as both companies didn’t ask us about any pre-existing disease. If they would have asked us then we would have declared it at the beginning. Lots of people are disappointed and frustrated with most of these insurance company when they receive rejection letters and finally they are forced to pay cash and discharged their loved ones without proper treatments just like I did the same. I discharged my wife on the 21-Oct-2021 from the Mata Chanan Devi Hospital.

I would like to request you to re-imburse me what I have paid as according to all the hospital bills If the Care Health Insurance will be able to do that. Otherwise I shouldn’t have insurance policy if I have to pay cash for everything that would have been better. The Care Health Insurance people gives us so much of trust and fake smiles that they will insure and give us our total claim amount when we get admitted into the hospital or when we get sick. Please re-imburse my claim amount if its possible. I am attaching all documentations for my re-imbursement. Should I not get re-imbursed I will then have to cancel my policy with care health insurance.

Many Thanks

Manish Kumar

Cell number: [protected], [protected]