I Ram Babu Dubey have take a health insurance plan from LIC through a agent Mrs.Pankaj around 2 years back. All the applicable test were conduct and then only the policy was issued to us. In 2010 june it was found by doctor that i was having a artery blockage and i need to go under a Angeoplasti. I called my insuracne agent to confirm if this is coverded under the surgery list and confirmed the same that we can claim for this suregery then after my surgery on 7th jusly i came back and called my agent to file the claim then then she told their is no time limit so we can claim this when i recover after 20 days when i called her she provided me the claim form in which it was mentioned that we have to get the signature from the doctor. As i am livinv in lucknow and i was operated in Medanta Medicity Gurgaon i send them the papers and for futher procidings and the took another 20 days to resend it to me on my continues follow up to them after which i filed my claim. But when i was fileing the claim my agent told me that the calim should be processed in 1 month from the operation and she was not clear on this eairlear but never the less she told that she has submited a exception letter in the company and it cleared now.
Now after 50 days i am getting a letter from the company that my claim is reject on 2 grounds 1.I have submitted the claim after 30 days and 2. The surgery is not included in the list of 49 surgerys provided by the company and my bill of 264000 has been rejected. Now on this i am looking forward for a leagal claim and planning go to court to find a fair claim on my expenditures. LIC is claiming that i have filed the claim after 30 days which their agents miss guided us and from their end i am getting a rejection letter after 45 days.