Refer my Policy Number : HA0000140100106

This policy was taken in the year 2003 for a Sum Assured of Rs.1,00,000 (One Lakh) each covering my 4 family members. Self, Wife & Two Daughters. Every year I have paid premium & have not claimed a single paisa as a result I was give Rs.60,000/- as bonus against all my 4 family members. Today, all 4 members have a cover of Rs.1,60,000/- each.

On 06/03/2010, I intimated Royal Sundaram that my Wife is ill and she has been diagnosed with Cataract and doctors have advised immediate Operation for cure & regain of health. The approx cost given to us by the doctor for Rs.45,000/- for each eye, since she has cataract on both eye the total cost etimated is Rs.90,000/-. I prayed thankfully that I had taken this mediclaim cover.

To my surprise, when intimated to Royal Sundaram as a Pre-Notice for the claim, I was shown a rule taken out from the Text book, which was not shown earlier nor told neither I have signed any such document to Royal Sundaram that each illness has a specific percentage for Claims and for Cataract it is Rs.7500/- only which is 7.5% of Rs.1,00,000/-.!!

Since all these sounded Rubbish to me, I escalated the matter to their Corporate Office in Chennai, spoke to their so called responsible officers & also asked if they have any such signed copy from my side where their so called Rules were told to me and were accepted by me, Royal Sundaram had non.

My point of view it, Illness if not pre-determined nor any one falls ill as per anyone's Terms & Conditions this is highly irresponsible, Cheating, Fraud being done and still being carried by Royal Sundaram in the name of Medical Insurance which for all practical purpose is no where there for the customer nor it is of any use.!!.

I wrote to them to refund me Rs.50,000/- this includes my 6.5 years of Premium Paid along with Penal Interest Or Else Pay Rs.1000000/- (Ten Lakhs) as compensation for Cheating, Fraud, Hiding facts & Mental harrasment to me.

I am enclosing attachment, which will have my email correspondence with Royal Sundaram, this would also include a letter addressed to their MD for which they have very clearly stated they will not refund me my 6.5 years of Premium with Penal Interest (Rs.50,000/-) nor would they accept Rs.1000000/-(Ten Lakhs) as a penalty.

It seems they do not wish to follow any law of the land nor they wish to keep the santity of the Insurance intact hence I am forced to write to Consumer Forum for justice & since Insurance has sentiments, emotions and criticality involved the matter should be very strictly viewed and not only help get justice also Royal Sundaram needs to be severely repremanded for this cheating.!!.

Regards,
Abhijit Ghosh
09811806932

Sir,
I am Dr Simmi working as a consultant anesthesia at Faridabad.
This letter is in response to cheating being done by the insurance agents to add a policy to their account at the cost of inconvenience and loss to the isurer.This is regarding my professional indemnity policy no 361102/46/09/870000668 issued fron the office of general insurance sector-16 faridabad on 16/3/2010(dev.officer/agent;22879/20543). My previous policy no is 361102/46/08/8700001252I . called Mr V.K.Taneja at the same office to renew the policy with same term and conditions.He asked me to give the cheque of Rs2753……after some calculations, if more is required he will pay and later will take from me.I gave the cheque and the photocopy of the previous policy.When I got the policy the policy was completely changed to accommodate the amount.This was don last year also. Manager of the branch is also involved in this,as last time also he totally refudsed to refundand took the side of agent MR Verma and told that this is the company,s policy and he can not do any thing.The refund was made after the same complaint to IRDA and head offices and regional offices.Heard of increasing the risk cover, but never heard of decreasing the cover when a person can afford the premium.
I am constantly asking MR Taneja from 18/3/2010 to rectify my policy to the original term and conditions,but all in vain.He says his company is not doing the professional indemnity policies.I want an answer from the top officials to justify their agents wording.If company is not doin ,then how the policy was being done earlier and how he did it with changed terms and conditions.
Dr.Simmi Dua
9818877224

The copy of the previous complaint is this
I am writing this after being harassed by the branch office -2 Faridabad manager Mr.Dhariwal and his agent Mr.Rajeev Verma. My professional indemnity policy was due on 15th march 2009 policy no-361102/46/068700000782. last year premium was Rs.3367,so I gave the cheque of the same amount to Mr.Rajeev Verma, who told me that Govt has increased the premium which is now Rs-6618. Believing Mr Rajeev Verma I gave the cheque of Rs 6618.When I got the policy the it was deliberately altered to compensate the cheque amount without my information. The new policy no. is--361102/46/08/8700001252. In this they have reduced the onetime payment to RS- 950000 instead of my previous-RS- 1000000,and deliberately increased the sum assured to Rs-2850000.

I enquired from my colleagues and other branch offices and agents there is no increase in the premium in fact there there is reduction in the service tax so the premium would be little less than the previous year. I am trying to meet Mr.Dhariwal manager branch 2 sector 16 Faridabad and his agent Mr.Rajeev(CODE no-361102)for the last many days but all in vain.Yesterday I met Mr.Dhariwal branch manager he straight way told me that its increased by the Govt increase so he can not do anything,He can change the the policy to the old term and conditions but the premium would remain the same ieRs- 6601. Every other person in the same branch as well in the branch-I Faridabad is ready to renew the policy in the same terms and conditions and that too in the same premium of Rs 3367 except MR Dhariwal and his agent MR Rajeev Verma.

Please do the needful against the manager and the agents like this to avoid the inconvenience caused to the public and spoil the image of the company, I request you to change the policy to the old term and conditions and refund the balance of Rs-3251.

Thanks

DR.Simmi Dua dated
28.3.2009

Consultant Anesthesia
Sun Flag Hospital Faridabad