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सफलता की कहानी / Success Story #3103991

NCH Docket No.: 3103991 Dated: 2021-11-17 Sector: General Insurance
Problem Reported: Consumer has taken a health Insurance policy from a Private insurance company in the last week of August 2020 and paid the premium amount of ₹15,000/- for the tenure of 1 year. In March 2021 he was COVID positive and was treated in a hospital. After recovery, consumer had applied for the claim but the company rejected the claim with the reason that he had got mild COVID Consumer had submitted all the required documents to the company and wanted the claim amount.
Escalation by NCH: As the insurance company is a convergence partner of the National Consumer Helpline, the grievance was responded by the company on the NCH Portal that ‘Based on the additional information and clarification provided to us, medical panel has re-examined the claim records and opined to consider the claim as per policy terms and conditions. Accordingly, we have processed and approved the claim for ₹77384/- after deducting non payable items as per policy terms. The payment has been processed through NEFT.
Consumer Remark in INGRAM: Excellent. Good job done by team. Thanks for your support. My reimbursement issue resolved. Pls. support the needy
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