I had taken a Hospital Cash Insurance Plan based on the tie-up between Royal Sundaram Insurance and SBI cards. Since then I was paying premium for the past 7 years.( The latest one is valied from 06.08.2015 to 05.08.2016. Policy no. CSP000xxxxxxx107.I was hospitalized from 07.10.15 – 9a.m to 10.10.15 – 12.30 p.m( 3 days) . I submitted my claim papers on 29.10.15 which was promptly acknowledged by them through SMS on 31.10.15.As per the policy terms, M/s Royal Sundaram Insurance company should have paid my claim for the number of days of my hospitalization. Till date M/s Royal sundaram had not settled my claim.’Royal Sundaram= 842-811’ - Hospital Cash Policy - Not settled - abnormal delay, compensation claimed.The date chart1. I had submitted the claim on 29.10.152. Received first SMS confirmation on receipt( acknowledgement) on 31.10.15( from Royal Sundaram) 3. First complaint lodged by me on 29.11.15; 4. Acknowledgement of complaint received on 30.11.15 by e-mail by V. Vijayalakshmi( CS executive) .( Ref: no. 826-229) 5. Second complaint was lodged by me on 5.1.16; 6. Acknowledgement of second complaint received on 08.01.16 by e-mail by by Rajesh K.( CS executive) ( They gave fresh ref number 842-811) 7. Since there was no fixed commitment, and not having faith on their call centre, sent another prompt on 09.01.16 stating abnormal delay.8. Got a e-mail revert on 14.01.16 from Danny( CS) stating that they will revert in 7 working days.9. lodged an E-mail Complaint to Ombudsman, bimAlokkrpl.chennai@gbic.co.in on 11.01.16. No response from this team/office. My request to your team to intervene and expedite the claim settlement did not yield any result till date.10. Received another SMS from Royal Sundaram on 27.01.16 at 18.15 confirming approval of my health insurance claim - for payment of Rs.4, 000/-. Informed that the details of the claim workings will be shared within 2 working days.11. On 17.02.16, I had sent another e-mail & physical mail to bimAlokkrpl.chennai@gbic.co.in with copy marked to M/s Royal sundaram. Royal Sundaram had sent me an automated acknowledgement but I had not received any acknowledgement nor revert from BimAlokkrpl till date either for my earlier representation made on 11.01.16 or on 17.02.16.12. Since I did not received any response from Ombudsman too till 22.02.16, I had represented to Consumer Affairs Department, Insurance Regulatory and Development Authority( IRDA) by e-mail on 22.02.16.13. 23.02.16, & 15.02.16, I received an letter from Ombudsman through courier asking for copies of Insurance policy( end to end) , original letters, letters addressed to legal department of Royal sundaram insurance etc., The issues are, a. Till date I had not received the claim amount. There is an abnormal delay. Royal Sundaram is lukewarm and not settling the claim.b. The cust service number 18604250000 was not working on many days. Even if it works, I could not connect to their staff even after 10 minutes. From hearsay, It appears that there is fixed timings. If so, why not they incorporate an auto message? c. India is promoting Digital revolution. Why Ombudsman had not responded to my e-mail is sent on 11.01.16. Even they had not acknowledged receipt for my e-mail 17.02.16. Only when I sent a physical letter in addition to e-mail, they had responded. What does it convey. Are they not capable enough to respond to e-mail by way of acknowledgement or they do not treat it as valid communication? What is wrong in acknowledging receipt of e-mail? d. When I had forwarded all the mails which I had sent to M/s Royal Sundaram along with the date chart, my policy number, complaint reference number, why they are instructing me to again furnish physical copies of the complaints. In their letter which I received recently they had instructed to produce a copy of my communication addressed to/from the legal department. If so where is the address available on the website of M/s Royal sundaram? . I am subjected to pain and agony. It is really a torture by Esteemed Royal Sundaram Insurance. How are they going to compensate for the mental agony, pain and sufferings I had faced on non receipt of my claim and the time & labour spent I had spent for following up with M/s Royal Sundaram and other bodies like Ombudsman & IRDA & for the calls made to call centre? .e. What sort of Governance do Royal sundaram they demonstrate? Unquote: I suspect that some miscreants in Royal Sundaram or TPA are trying to cheat me. I expressed my apprehension to IRDA on 22.02.16 and requested them to treat it as Whistle Blower also.In the mean time, I will be sending my physical papers to Ombudsman. Let us see the outcome.The views expressed by me is personal and are my true experience/fact for which I have documentary/digital evidence. Neither my Profession nor my organisation with whom I am associated/employed( past/present) are responsible. My organisation( employer) will not responsible for my above review.
Additional piece if information:
This company prefered not to renew my insurance policy next year onwards ??. they lost the relationship of my family of 4.