Bajaj Allianz General Insurance Company Ltd.
- Wrong settlement of mediclaim policy Open
Sub. Wrong settlement of the cashless claim of my wife Kumkum Bhagoliwal
Ref. *- Order No: HAT/**/*******
*- Claim No: OC-**-****-****-********
Kindly refer to your mail dated **th April **** on the above-mentioned subject stating that:
“As per the policy terms, there is a waiting period of * years for the joint replacement surgery, where * years has been completed by * Lakh sum insured and not by * Lakh sum insured. Hence the applicable sum insured has been confirmed to be * Lakh + Cumulative bonus of *****/- as per policy terms.”
In this regard, your attention is drawn towards Item No. * of page * of the Health-Guard Silver Plan Customer information sheet provided tome which clearly states that:
“Any medical expense incurred during the first ** months during which you have the benefit of a Health Guard policy with us in connection with:
• Joint replacement surgery
• others not related to the present case”
I have the Bajaj Health Guard Policy without any break for approximately **-** years. Nor the disease was pre-existing when the policy was purchased.
Therefore your decision is not as per the details mentioned in the policy. The **% discount amount is also arbitrary.
You are requested to kindly reimburse the balance amount from as per the total sum insured of *,**,*** + ****** (Cumulative Bonus) immediately failing which I will have to undertake all legal recourse available to me. I have already suffered financial loss in the form of interest for borrowing the amount and huge mental stress due to the irresponsible and callous attitude at your end. Soliciting an early reply.
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