Sir,

I first enrolled for ICICI health care policy for my parents in 2009. I made the second renewal in Feb 2011 by paying a premium of INR 30,000.

On 2nd of October 2011, my father got admitted at Max hospital (Saket, New Delhi). I applied for the cashless claim and the insurance company told me that no policy existed in name of my father.

After continued struggle for more than 10 days (emails and calls at callvcenter), they acknowledged that the policy did existed in there records (though I had recieved a copy via email after renewal)

Now, when the TPA at hospital applied for the cashless claim, they rejected the claim giving reasons of alcohal abuse. I clarified with the help of doctors case summary, that my father did not consumed any alcohol atleast in the last three years. I reapplied for the reconsideration but ICICI lombard denied the claim again. Ironically, the treatment was related to internal bleeding and respirational pneumonia.

The policy coverage amount is INR 6,60,000. End of October my father was discharged from hospital and I had to pay amount close to INR 10,00,000 to the hospital from my ow pocket inspite of having policy.

Herewith, I look forward to consumer court to bring justice to the case and provide me with reimbursement.
I am also looking for experienced lawyers who can take my case forward.

With Best Regards,
Vikram Jain
Mobile 8750300536