A little long, but worth it.
Had a policy with the jerks, with the TPA as one FHPL(Family Heathcare .). One of the worst experience of my life when my Mom-in-Law went on for a planned surgery in Mar 29’2006. This was pre-approved - cashless.
In Sept 2007, got a call from the hospital that the claim has been rejected(after 1.5 yrs!), but nothing in writing. When called, the TPA person told me that I should be thankful that they gave the approval based on which I did not have to pay that time, but the policy was rejected b’cos it was’Out of Period’ . i.e. policy was live from 15/4/06. On asking why the approval was given was told it was a verbal committment given by ICICI Lombard. After long xchanges of mail.
I complained to IRDA(the guys are scared shiot of them) and filed a case with Consumer Court against the TPA. The hospital also helped with a letter that they did not get any intimation . the TPA countered that they had sent the letter in June’06. WON THE CASE today and the TPA has to pay everything . damages yet to be announced.
Consumer court works! The guys had no reply to the facts and proof submitted . they had the nerve to say that I should have files a case against ICICI Lombard. I had sent a mail to ICICI Lombard but they did not even bother to acknowledge receipt or reply to the same. Need to give it back to the bas*ards . By far, one of the worst company I have ever dealt with in my life . the whole ICICI Group. Just don’t take things lying down and screw their happiness complaining to RBI Ombudsman for bank related stuff and IRDA for Insurance.