Religare Health Insurance — Reimbursement claim rejected

Address: Bangalore, Karnataka, 560043
Website: www.religarehealthinsurance.com

Dear religare team,

First of all thank you for rejecting my claim.
It was very easy for you people for rejecting my claim and it was tough for me, because i had paid the premium for past 3 years from my hard earned money from my credit cards through emi.
This premium was charity for paying salaries at religare and they have enjoyed it very well i believe.
Religare claim status states that i have hypertension and headache from past 8 years and i was treated for that.
Your customer care says that as per indoor case study report i am patient for hypertension for 8 years, and i didn't disclose that during taking this policy.
I know you people will reject all the policies because 2 days back i saw in times of india a comment stating religare is in cash crunch.
First of all, if a patient gets admitted to a new hospital, what happens of they have new staff, they take care well, they ask each and every problem.
If say i have headache from past 5 days that doesn't mean i have tumour and i am getting treatment from 8 years.
If i say i have stomach ache that doesn't mean i don't have intestines and they are treating from past 8 years.
Let me ask, if you get admitted and intimate the policy provider, than they process for it.
Than they send an 3 party investigater he comes to your bed in icu takes the snaps of your records each and every page, doctors write some of the daily activities of the patient.
He scratches on some pages.
#
It is indoor case study and all the non sense you people are not the insurers, you people are some kind of gamblers who want to fool people with there health.
On grounds of my general discussion with doctor you people are stating that i have hypertension and headache for past 8 years and rejecting it and asking for justification letter for my treating doctors, prior to this i didn't have any kind of doctor who was treating for hypertension nor i had regular hypertension.
I have already shared all my original reports and consent letters.
I got admitted due to headache 0n 30/052017 and they took me to casualty and gave me some medicine, to stop my headache.
Later they took me to icu and kept me on drips and medication. Later have some injection through some machine.
They than told i required to continue staying in hospital till my bp calms down.
They kept till i became normal and i intimidated religare they sent some one to investigate and that person came to my place and started taking snaps of me on the bed and the files.
He left from place and came back he told me to fill some forms that were 5 to 6 pages and again my hypertension went up to 180. I started swetting.
After 2 days treatment in icu, i was shifted to the room for further treatment.
On 02/06/2017, i got discharged and i was told be on insulin and medicine for hypertension and this was new to me.
I started getting giddiness doctor told that it will take time, till my body accept the normal hypertension.
Than i received a mail from religare stating they want all original reports and scans to there correspondence address. I couriered them through bluedart express paying rs. 500/-.
I kept calling customer care for the status after some days i got a mail stating i required to send indoor case study reports again i couriered from bluedart paying rs.500/-.
I kept calling religare customer care they told that still investigation is underprocess in which some security and criminal investigation happens.
Please check for customer care call records about this.
Than i got the investigator that he is coming from chennai and will come to my house.
The next day he came and he was the same person.
He met me at hospital and he asked for the doctor at reception they told doctor will be available at 5:30 pm and he took the scans of indoor case study again and he came to my new joined office and he told me to fill all documents.
Than he gave me some papers that should be filled by doctor and since it was 1:30 pm and more 4 hours were there.
I met the doctor at 6:30pm and doctor filled and stamped the deal.
Later i met the investigator at his location and handed over the doctor documents.
I again kept calling customer care for the status they told it will take again 30 days from the pending documents submission.
My hypertension again went on because the due date for payment of my credit card bill that was swiped and shared the acknowledgement to religare at hospital is nearing and the religare status and investigation are delayed.
Finally, yesterday that is on 21/06/2017 religare declined my claim stating that hypertension was pre-existing and i did not declare that during taking this policy.
I called your customer care yesterday night and he asked me how is my health and i asked why my claim declined.
He checkedand told that as per indoor case study from past 8 years i am having headache and suffering from hypertension and no medication.
If i tell them to check there efficiency that become a concrete proof for you.
You people will reject my claim.
Than what about my bills paid for hospital rs: 30000+27000=57000 by credit card ending with 1002, stationary, couriers.
Thoes are charity or just a gimic by you people.
Just screw up a patient, by ruining his time and health.
After this my health is worsening more.

I have no words after paying insurance policy on time for past 3 years without any default, by emi from my hard earned money from credit card.
I only have some dummy plastic cards.
Hope you people enjoyed my money.

Regards
Rahil pasha
[protected]

On 12 jun 2017 12:01, "rahil pasha" wrote:
Dear claims team,

Please find the attached screen shot of the pod of the mentioned required docs and the acknowledgement.
Hence, there are no pendind docs from my end.
Please look into this and process for reimbursement asap.

Regards
Rahil pasha
[protected]

On 10 jun 2017 15:46, "rahil pasha" wrote:
Dear claims team,

I rahil pasha bearing policy no: 10144947, have not been treated nor diagnosed for diabetics and hypertension.
Please find the attached hand written snap shot and pdf of the declaration.
Please find the attached scanned copies of indoor case report and the courier acknowledgement of the same by bluedart couier awb: [protected]

Regards
Rahil pasha
[protected]

On 10 jun 2017 14:58, wrote:
Dear sir/madam,
Please find the attached query letter of rahil pasha

Thanks and regards
[protected]
[protected]
WWW.religarehealthinsurance.com
Claims department
Religare health insurance company limited
Vipul tech square, tower c,
3rd floor, sector - 43,
Golf course road, gurgaon - 122009
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2 Comments

Comments

Hi rahul pasha, I am also policy holder of other insurer & I wish to share some infirmn based on my experience, which may or not useful. As you stated insurer rejected your claim on basis of indoor papers mentioning preexisting of hypertension/head ace since 8 years. Pl check copies of indoor papers & check if there is any narration about pre existing condition & there is no way to reject your claim if there is no such narration. Insurers version that w/o any treatment you have suffering from hypertension/headache prior to policy is not valid since patient cannot survive for a such long period w/o treatment, which may leads to cardiac problems & other complications. Insurer cannot imagine/conclude these things w/o any documentary evidence. Health check up might have taken, where in it would have revealed about hypertension before issue of policy, if so how they have accepted your proposal & issued policy with 2 renewals? this has to be answered by insurer. If you are sure that your treatment is first time, you may approach insurance ombudsman for your grievance against insurer.
Hi all,

Patient- Abhishek Sharma
Policy no[protected]

This is to bring to the notice that I am the patient admitted in the hospital for last 3 days under dengue report shows positive and under treatment for said many days, Religare insurance has declined by hospital claim for payment, I am stuck in the hospital for non payment by Religare insurance to Paras Hospital, Gurgaon

Almost 3 days back I got admitted in emergency of paras hospital, Gurgaon, bcoz I was suffering from fever from last 5 days on n off full day. I was not able to walk properly, full sweaty body, drained energy, giddyness state, fever, not able to think or decide but except knowing it's hospitals emergency who will look after, now after treatment n reports I was found dengue positive and was admitted by the hospital. Now after 24 hrs harrassment by Religare health they have declined the case even inspite of providing complete evidences of treatment n reports n letters of doctors stating my condition of entering the hospital.

What should i do as a patient?

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