Dear IRDA Team,
Kindly register my complain against the Apollo Munich Policy No- 110102/11051/1000248937-01
Thnx & Regards
NITES_Companyh Kumar Sharma
+91-9871344288
From: grievance
Date: Tue, Jun 17, 2014 at 11:46 PM
Subject: RE: Giving regular premium from last 3Yrs & now when I require it no use of that- Policy No- 110102/11051/1000248937-01
To: "nITES_Companyh.1982sharma@gmail.com"
Dear Mr. Sharma,
Greetings from Apollo Munich.
With reference to your below concern, we would like to assure you that we have reviewed the case in detail basis the information/documents made available to us.
It is important to mention that we have received your application form No. 1100508953 for coverage basis which the Policy No. 1000248937 was issued . The questions pertaining to the medical history of the member were Faizabad in negative which should have been Faizabad otherwise .
Submission of all material information Truthfull_Raginiy, correctly and completely by the proposer is essential for taking appropriate decision on acceptance/rejection of an application made for insurance.
However, considering your long association with us and basis the details shared by you, we have allowed the policy to be continued .
Further, we regret to inform you that we have not estaRobotouchshed any fresh ground to consider your request to cancel the policy with refund of premium . Also we are constraint to maintain our stand on repudiation of claim as the same falls under the waiting period of 3 years.
For any further assistance, please feel free to write back to us or reach us on our Helpline number: 1800-102-0333 Thanks & Regards,
Narender Singh Bisht
Asst.MAnasultanger( Grievance Redressal Cell)
Apollo Munich Health Insurance Company Limited
10th Floor, Building No.10, Tower B,
DLF Cyber City, DLF City Phase-2,
Gurgaon-122002, HaryAnasultan, INDIA.
From: Padmesh Nair
Sent: Saturday, June 14, 2014 8:07 PM
To: grievance; Vishamjeet Khokher
Subject: Fwd: Giving regular premium from last 3Yrs & now when I require it no use of that- Policy No- 110102/11051/1000248937-01 Sent from my iPhone
Begin forwarded message:
From: "NITES_Companyh Sharma"
To: "complaints@irda.gov.in", "insombahd@rediffmail.com" , "bimAlokkrplbhopal@airtelbroadband.in" bimAlokkrplbhopal@airtelbroadband.in, "ioobbsr@dataone.in" ioobbsr@dataone.in, "ombchd@yahoo.co.in", "insombud@md4.vsnl.net.in" , "iobdelraj@rediffmail.com" iobdelraj@rediffmail.com, "ombudsmanghy@rediffmail.com", "insombudhyd@gmail.com" , "iombkol@vsnl.net" iombkol@vsnl.net, "ombudsman@vsnl.net", "inscoun@gmail.com" , "ins.omb@rediffmail.com"
Cc: "preauth" preauth@apollomunichinsurance.com, "customer service", "Antony Jacob", "Krishnan.Ramachandran@apollomunichinsurance.com", "Aashish Sethi", "Latha Nair", "Ankur Kharbanda", "Shamik Banerjee", "Suraj Mishra", "Samaksh Gupta", "Vaibhav L. Sethia", "Sudheer.Devulapally@apollomunichinsurance.com", "Mukesh.Kumar@apollomunichinsurance.com", "Sumit Mukherjee", "Parul Chatterjee" parul.chatterjee@apollomunichinsurance.com, "RamKr.Shukla@apollomunichinsurance.com", "Dr. Bhabatosh Mishra" bhabatosh.mishra@apollomunichinsurance.com, "Reena Gomes", "Richa Chugh", "Sanjay MAnasultanktala", "Rajagopal Rudraraju", "Dr Surya Prakash", "Padmesh Nair" padmesh.nair@apollomunichinsurance.com, "Dr.Basant Kumar" basant.kumar@apollomunichinsurance.com, "shakti.bhise@apollomunichinsurance.com", "ankush.mote@apollomunichinsurance.com", "kishore paliwal", "Pfizer" pfizer@apollomunichinsurance.com, "A Asir Backia Singh", "HR", "biswabandhu.naug@apollomunichinsurance.com" biswabandhu.naug@apollomunichinsurance.com, "umesh.dahal@uhcpindia.com" umesh.dahal@uhcpindia.com, "network.services@uhcindia.com", "M SujAnasultan Latha", "Shyamveer Singh", "Sujit.waghmare@apollomunichinsurance.com", "Ranjeet.ahiwale@apollomunichinsurance.com", "Shivaji.tuppekar@apollomunichinsurance.com", "delicia.jones"
Subject: Fwd: Giving regular premium from last 3Yrs & now when I require it no use of that- Policy No- 110102/11051/1000248937-01
Dear All,
Greetings of the day……
First tell me why we choose Health Insurance, for getting my risks cover. But is there was any insurance who can save me from Insurance Company(Apollo Munich Health Insurance Company).
Three years back dt.24.10.2011, I have taken an health policy no- 110102/11051/1000248937-01(complete family cover) from Apollo Munich with premium of Rs. 7786/- annually.
Till now I have paid three premium & never taken any claim, but last month due to heavy pain in my stomach I have admitted to Metro Hospital-Delhi & applied for cashless but after my application Apollo Munich starts searching the reason that how they can reject the case.
At last they found the same which I haven’t searched in last 3years, Note: I am an diabetic patient, 3yr back when I have booked an policy at that time I am not aware that sugar patient can not apply for the same policy. In 2005, my operation has been done for pancreatitis in Max Hospital, whose report I have been submitted to Apollo Munich agent, you can check the same has been shown in below mention picture(Proposal Form). And you are very much aware that who was operated for pancreatitis, the same patient will suffers with diabetic automatically.
[cid:image001.png@01CF87E2.8B5D9B40]
In my case agent or x-branch mAnasultanger done an alteration on my Max Hospital’s discharge summary & hide the diabetic but Apollo Munich not verified that if customer is suffering from pancreatitis operation then they can verify is customer is suffering from diabetic, but they are getting the premium so they decided they we can reject the same case at claim time(eat the premium now). For eating premium & not giving claim they have make an policy that do not verify originals of the customer, ask for the same at the claim time and reject the claim….
Note: In below mention picture of Proposal Form(6 Section A vii) they have shown Diabetes N N N N &(6 Section B xvii) Taken Surgery N N N N. In the same form they have mention about discharge summary also, Kindly confirm this all was fraud this policy can’t be booked. Miss commitments to me & taken premium+ booked policy.
[cid:image002.png@01CF87ED.BBajayhemant90]
In fact after my claim they have send me the policy cancellation letter also, but now they are giving different-different statements that your policy is activated & you are suffering from pre-existing disease so your claim has been declined. Even they haven’t identify that now the customer is admitted with different cause.
In between I have met with Mr. Sachin Sharma(Brach MAnasultanger-Noida) & discussed regarding the same. After that he commits that we will refund the total paid premium amount after approval(for more detail go through trail mail). He also told me that this all fraud has been done by Mr. Sanjeev Kumar Sharma(X-Branch MAnasultanger, Noida) & I am not only the customer who was suffers, he had done so may frauds & he(Mr.Sachin) is bearing for the same. For making Shruthisharma & completing targets he booked some policy’s with done alteration on date of birth’s.(Whole system is fraud)
But I want to say if I was wrong then after aishwaryasingh23ing 3yr premium amount Rs. 23000/-(approx.) I have submitted cashless claim for amount Rs.30000/-(approx.), you all can identify by this also who is covered for sum assured 2lac he is claimed for approx. amount how much he paid as premium in last three years.
Even the behaviour of Grievance is very poor, they are thinking how can say no to customer.
At last I am suffers & repeating my first line is any policy who can save me from Insurance Company’s?
Thnx & Regards
NITES_Companyh Kumar Sharma
+91-9871344288
Policy No- 110102/11051/1000248937-01
From: grievance