I had undergone surgery at SGPGI, Lucknow in February 2020 and submitted claim to M/s Religare Health Insurance, soon after, as per their format, providing whatever documents I had in my possession. The claim itself was a very nominal sum, SGPGI being a heavily subsidized, government institution.
From that day on, the torture started: Automated reminders for documents already submitted, senseless telephonic calls from company executives, asking for irrelevant and hilarious clarifications, blaming system fault, blaming COVID situation etc. this continued till August 2020, when I was forced to escalate the matter to the IRDA, which gave the company 15 days to sort out matters.
So within the deadline, I received a "congratulatory" message from M/s Religare, informing me that the claim had been settled. So is this the way, a health insurance company is supposed to operate? Harassing and intimidating the customer / patient, till the matter is finally escalated to the government authorities? How many of us have the wherewithal to pursue such matters relentlessly, and how many of us even know the channels of grievance readressal? All for a petty amount, which was 1/15 of the sum insured? What if the claim amount had been for several lakhs of rupees from a private hospital?
And is this really a "victory" - getting paid, what was rightfully due? After 6 months, and endless headaches?