Reliance General Insurance Co. Ltd. Policy No. 2825 1038 7431
Servicing branch: 4 & 5, ground floor, Palm Court, (near MDI)

Complaint related to health insurance against Insurer, TPA

Denial of cashless facility

Service request no. 784351 dtd. 3rd. Dec, 2009, and 804193 dtd. 12th Dec, 2009

This complaint is on behalf of all those people, who are lured into buying a policy, only to know that it is a worthless document when needed. This amounts to a breach of trust, and I urge strict actions against such fraudulent insurers. Although they claim to be top corporate houses, their attitude befits a ordinary thug.



In a nutshell, the insurance company was approached with a pre authorization request, which was denied stating that the case was OPD. Even after providing the doctor’s certificate and request to inform if any further documentation was required, (The company was handling this case under SR 784351 and 804193 and was contacted several times; Dec 7th, 9th, 11th, 12th, 14th, 16th, 17th, 18th, 20th, 21st, 22nd, 24th, 26th, 27th, 28th and today i.e. 29th) no explanation was forthcoming, nor was I explained why the doctor’s certificate was not taken into consideration, or given an opportunity to furnish any document to process the claim under cashless facility

I treat the denial of cashless facility and offer to go for a later reimbursement with suspicion as an earlier mail sent to rgi@mediassistindia.com, enquiring if a claim was admissible went unanswered, and in the present case too, no convincing answer was provided despite several calls and mails. The insurer refused to budge from it's stance, that the case was OPD.



Regards,

Manoj K. Agarwal
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