Subject: Cheating while taking policy and not approved the claim
My Name: Ankit Acharya
My Contact Email ID: [email protected]
My City: Mehsana
My Complaint Against: Reliance General Insurance
Complaint Category: Insurance Companies
Claim Amount (Approx.): 235000
My Complaint Description:
Please consider the below and enclosed as an official complain against Reliance General Insurance (Reliance) for the floater mediclaim policy # 1615742828000008.
We have been a Reliance client for over 10 years (Since 2006 onwards). Last year, we were informed of discontinuing the existing policy by the company and were suggested alternative offers for continuing the health coverage.
Based on the previous policy, the local Reliance representative recommended the floater policy of sum insurance of 3,00,000 for the husband and wife. Earlier our insurance costed us somewhere around INR 5,680 and with this floater policy, it is somewhere around INR 38,764. This is almost 7 times of the previous policy. We asked about this several fold increase and we were assured that this is floater policy so premium is high and anyone can avail INR 3,00,000 for medical expenses. We were never told that there would be any sub limit for each applicant during the application. Please find the enclosed document of the application.
On May 25, 2015, based on the discussions with Dr. Dimple R. Parekh of Parekhs Hospital, Ahmedabad, we submitted the documents for right knee replacement of Mrs. Bhartiben Acharya for caseless facility. The doctor has requested to be admitted at the hospital by the afternoon of May 27, 2015 so that the surgery could be completed on May 28, 2015. In the late evening of May 26, 2015, we received, a SMS from Reliance that only INR 92,000 has been approved for the claim of INR 2,35,000.
Since then we have communicated several Reliance representatives at the local office, toll free number and by email. Their response and services were worse.
They kept us on hold several times and disconnected the calls
Based on our request, they promised the timeline to respond; however, they did not call. On day before yesterday, it took over 90 mins to receive the response from them.
Their response is keep changing. Earlier they said that there is a sub limit of 115,000 for her. After deducting 20% from this as copayment, the amount comes 92,000.
In the latest telephonic conversation with the Hyderabad office, they responded that because of pre-existing alignment problem, we are approving 92,000. This is contradictory from earlier conversation. Furthermore, there was not any pre-existing condition when the policy was opted. Once over the phone, we denied for this excuse said that the phone is recording the person has stopped talking.