I got insurance in april this year. coincidentally, I got injured in may and my right shoulder required surgery. I asked our agent if it will be covered in the claim, he said yes as it is an uncertain injury and not any disease, it will be covered in the claim. I did the surgery then. submitted each n every document to head office. they wer not much responsive initially.
Then after a month they asked for some more documents from doctor. we submitted. after 2 months they sent an investigation agency to home. we gave MRI scans to them as they asked for it. after 10 days to that, they returned the MRI saying that the injury was genuine and required surgery. then I kept contacting delhi office, but no much help. they used to avoid answering saying that "it is under process". then after almost 5 months of submitting the documents, they again asked for MRI scans. we sent it to delhi office. then after 10 days, they rejected the claim saying that "it was an old injury" WTF!?
you go through a medical checkup before you are eligible for mediclaim.(at a very shabby and poorly maintained laboratory) if the injury was old, how come my pre-medical checkup came to be "normal"?
they r fraud. one word. I wud rather prefer Unique mediclaim, as my mom got the claim within a month when she went thru a surgery