HDFC ERGO General Health Insurance Co. Ltd
- HDFC Ergo Health Insurance Claim NOT settled by Insurance Company Open
Sharique Rais filed this complaint against HDFC ERGO General Health Insurance Co. Ltd on Mar 19, 2020
HDFC Ergo Health Insurance - Claim NOT settled by Insurance Company
**. I, Sharique Rais have HDFC Ergo Health Insurance of INR * Lakhs vide Policy No. **************** valid from **/**/**** to **/**/****.
**. I was admitted to Indraprastha Apollo Hospital, Sarita Vihar, New Delhi in EMERGENCY on **/**/**** for being unconscious for more than * hours.
**. Indraprastha Apollo Hospital is a network hospital of HDFC Ergo Health Insurance which entitles me CASHLESS treatment.
**. Surveyor of HDFC ERGO demanded bribe and I denied. He filed a wrong report of probability of pre-existing disease which is totally FALSE and my CASHLESS facility was rejected.
**. I was told to pay from my own and later file claim for re-imbursement. Since, I could not afford my costly tests and treatment on my own, I paid my final bill by money borrowed from friends and took discharge from Apollo Hospital by taking leave against medical advice.
**. I filed re-imbursement claim shortly after few days. I submitted each documents (discharge summary, test reports, bills, payment receipts etc.) requested by insurance company.
**. Now, HDFC ERGO is delaying and denying me the re-imbursement by raising queries which are already been answered.
**. Underline cause/ Etiology of Syncope is NOT provided by the treating doctor of Apollo Hospital as cause of ailment was not confirmed and was under evaluation at the time of my discharge from hospital against medical advice.
Please file cases in suitable courts of justice against my insurer (HDFC ERGO) to pay me my reimbursement amount ASAP and a suitable amount in extra for causing me mental agony and distress.
Thanks and Regards,
Patient Name : Sharique Rais
Mobile: +**-**********
UHID: APD*.**********
Patient Identifier: DELIP******
Hospital Name : APOLLO HOSPITAL
Hospitalization Period : FROM **/**/**** TO **/**/****
HDFC ERGO ID : ER**********-**E
CCN NO : RR-HS**-********
POLICY NO.: ****************
VALID FROM: **/**/****
VALID TILL: **/**/****
Are you brand?
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Resolution Demanded:
Apology letter from company
Replace / Fix problem
Damages for loss and agony
HDFC ERGO General Health Insurance Co. Ltd
Resolved
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