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Religare Health Insurance - Declined my claim

Vikas Samota filed complaint against Religare Health Insurance on May 24, 2019

I am writing this email to express my utter disappointment on the cashless disapproval of my health insurance claim for my admission to Artemis Hospital in Gurugram from **/**/**** to **/**/**** for treatment and workup of my ongoing severe headache. This is how the chain of events unfolded. I was suffering from a severe headache for about two days despite using over the counter painkillers like paracetamol which reduced the severity of headache temporarily. Then on **/**/****, I went to Civil Hospital Jhajjar and was seen by a doctor who checked my eyesight and BP and prescribed some more painkillers for a week. I took the medications as prescribed with again just temporary relief and then the same headache bounced back. Then I went to Dr Manber Singh chokar for a second opinion who made a provisional diagnosis of Migraine and advised me to take anti-migraine tablets for another week. I took those tablets as prescribed but again had no effect on my headache. Annoyed and debilitated from the headache and fearing of a serious medical problem, I went to Artemis Hospital’s Neurology OPD where I was advised by the doctor to get admitted for further testing as the headache has been ongoing for two weeks despite significant treatment as an outpatient.
I had multiple blood tests, eye tests and an MRI Brain during my admission as advised by the neurologist to rule out any serious health condition and which suggested that I have a suspicion of Glaucoma (an eye problem) and also MRI showed I have acute sinusitis. I was given some medications from my veins which helped with my headache to a better extent. I was discharged from the care of the Neurologist with an ENT review in OPD for suspicion of glaucoma and further follow up in Neurology OPD after the discharge treatment.
I was discharged with antibiotics, painkillers, nasal sprays and drops from the treating doctor. On my discharge day, to my horror and disbelief I realised that my cashless claim was not approved from Religare based on the fact that I was only given paracetamol in the hospital but as you can see above that this admission was not about just getting rid of the pain but also to find out the cause of my severe and debilitating headache and to rule out any serious health condition like tumour or bleeding in the brain.
I had to face embarrassment in the hospital and had to arrange the money on my discharge through my credit card in hurried and chaotic circumstances which could have been avoided if the cashless claim was approved which exists for this very reason.

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Complaint Status

Resolution Demanded:

Refund / Credit for purchase

Damages for loss and agony

Religare Health Insurance

14

Total Complaints

5

Total Resolved

35.71%

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