Complaint Details

Status	:	Closed
Complaint No	:	0014743/2014
Category	:	Insurance
Date	:	03-02-2014
Subject Line	:	CLAIM SETTLEMENT ISSUE OF 7115/- RS.
Complainant	:	SANJAY TIWARI
Address	:	FF-3, SECTOR-5, PLOT NO. 762, VAISHALI, GHAZIABAD
Complainee	:	HDFC ERGO GENERAL INSURANCE COMPANY LIMITED
Address	:	6TH FLOOR, MBC TOWER, OLD NO. 90, NEW NO. 199, LUZ CHURCH ROAD, MYLAPORE, CHENNAI

Complaint Details
COMPLAINT AGAINST HDFC ERGO GENERAL INSURANCE COMPANY LTD.

TO WHOMSOEVER IT MAY CONCERN
DTD. 19/01/2014 REQUEST REGARDING CLAIM ISSUE WITH HDFC-ERGO CO.
my policy no. 51522141 (SANJAY TIWARI)
my hdfc ergo id no. ER1300807126-01E
my ccn no. RC-HS13-10100531-2
MY CLAIM NO. RC-HS13-10100531-2
dear sir/madam,
i "SANJAY TIWARI" want to say that i ve already sent the medical bills n prescriptions n reports thru courier on dtd. 16/jan/2014(including HDFC ERGO ID AND DISCHARGE SUMMARY COPY) to ur chennai claim deptt. office. Now i got message in my mobile i.e. my claim under process. After 3-days i called to claim deptt. on dtd. 19/jan/2014 regarding claim issue.
i had telephonic conversations with mr. SANDEEP(claim deptt.) regarding claim issue on 19/jan/2014. He told me that there is a query regarding claim issue.
He again insisted me to resend the scanned copy of "MEDICAL/HOSPITAL CERTIFICATE TO BE FILLED BY THE DOCTOR TREATING THE PATIENT AND DISCHARGE SUMMARY".
Now, i m sending all related docs. thru e-mail. Plz. go thru these docs. and solve my claim related issue asap.
thanking you,
YOUR'S SINCERELY
SANJAY TIWARI
09871570564(MOB.)
FF-3, SECTOR-5, PLOT NO. 762
VAISHALI, NEAR GOPAL DAIRY
GHAZIABAD, U.P. 201010

MORE....!!!!!!!!!!!!
TO WHOMSOEVER IT MAY CONCERN (DTD.-24/01/2014)
SUBJECT:-REGARDING TOTAL CLAIMED AMOUNT 7115/- RS. REVERSAL

MY POLICY NO. 51522141
MY HDFC ERGO ID ER1300807126-01E
MY CCN NO. HS13-10100531-2
DEAR SIR/MADAM, I"SANJAY TIWARI" WANT TO SAY THAT I,VE ALREADY SENT U THE RELEVANT DOCS. ON 16/1/2014(THRU COURIER) AND ON DTD. 19/1/2014(THRU E-MAIL).I'VE CLAIMED OF 7115/- RS. TOTALLY(I.E. INCLUDING MEDICINE BILLS, INVESTIGATION REPORTS AND CONSULTATION CHARGES).AND THESE THINGS ARE ACCURATE, TRANSPARENT AND GENUINES RELATED TO THE MEDICAL DISCHARGE SUMMARY, DOCTORS'CERTIFICATE ACCORDINGLY.
IN DISCHARGE CARD(PARAS HOSPITAL),PLZ. SEE ON DIAGNOSIS CATEGORY(PULMONARY KOCH MENTIONED WITH P. VIVAX MALERIE) AND ON INVESTIGATIONS CECT THORAX(I.E. RELATED TO PULMONARY KOCH EXPLAINED) AND SPECIFICALLY ON ADVICE ON DISCHARGE CATEGORY(THE MEDICINES AND PROTEIN RICH DESCRIBED). SO, THIS IS VERY-VERY CLEAR TO SAY TO U THAT THESE MEDICINES H

AVE TO BE TAKEN AFTER DISCHARGE FOR LONG TIMES.
AS IT IS ALSO MENTIONED IN YOUR POLICY THAT AFTER DISCHARGING FROM THE HOSPIAL; WE CAN CLAIM UPTO 90 DAYS FURTHER.(RELATED TO THE MEDICINE EXPENSES, INVESTIGATION EXPENSES AND CONSULTATION EXPENSES WHICH ARE ACTUALLY RELATED TO PULMONARY KOCH ALREADY MENTIONED ON THE DOCS. SUBMITTED TO HDFC ERGO)
I WANT TO CLEARLY EXPLAIN TO U THAT THESE MEDICINES EXPENSES ARE DIRECTLY ATTACHED WITH PULMONARY KOCHS. ALSO U CAN SEE THE PREVIOUSLY SENT DOCTOR'S PRESCRIPTIONS IN WHICH DR. HAS ALREADY MENTIONED CLEARLY ABT THESE MEDICINES AS TO BE TAKEN FOR FURTHER 2-MONTHS.
PLZ. SETTLE MY TOTAL CLAIMED AMOUNT OF 7115/ RS. AS SOON AS POSSIBLE ALSO WITH TRANSPARENCY.(THIS AMT. IS GENUINE, ACCURATE AND VERY CLEAR AND RELEVANT TO THE DIAGNOSTIC REPORTS ALREADY SENT TO U).
YESTERDAY ON DTD. 23/01/2014, I CALLED UR CUSTOMER CARE THRU WHICH I KNEW THAT U R SETTLING ONLY RS. 800/- WHICH IS ANY WAY NOT JUSTIFIED TOTALLY. WHAT-WHAT IS THIS TYPE OF CARELESSNESS ???? I'VE PROVIDED U THE WHOLE RELEVANT DOCS. U MUST SETTLE MY TOTAL CLAIMED AMOUNT OF 7115/ RS.; WHICH IS TRUE ACCORDING TO THE TRUE DOCS. PROVIDED TO U.
I WANT MY WHOLE CLAIM UPTO 90 DAYS AFTER DISCHARGE FROM THE HOSPITAL.. PLZ. TAKE THIS CLAIM ISSUE SERIOUSLY...OTHERWISE IT IS A GREAT COMPLAINT N I WILL FWDD. IT TO UR HDFC ERGO MANAGING DIRECTOR N POSSIBLY ALSO TO CONSUMER COURT....
I ALSO FINALLY REQUEST TO CLAIM DEPTT. PLZ. DO SOLVE THIS ISSUE ASAP. AND DONT GIVE TROUBLE/HINDER TO RESOLVE THIS ISSUE.
PLZ. DO SOLVE THE TOTAL CLAIM SETTLEMENT ON THE SERIOUS NOTES....??????
HOPE FOR THE BEST!!!!!!!!!!!!!!!
SINCERELY YOUR'S
SANJAY TIWARI
9871570564
FF-3 SECTOR-5 PLOT NO. 762
VAISHALI, NEAR GOPAL DAIRY
GHAZIABAD, U.P. 201010

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