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ICICI Lombard Health Insurance Image

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24%
1.46 

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Works with delay but claim settlement was full
Sep 14, 2010 09:00 PM 5770 Views

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My mom got her hand fractured, we went to an ICICI affiliated hospital(Khemka hospital Raipur(C.G.) for cashless benefit(and also coz it was the best for accident related treatments), the hospital's head Dr. said cash settlement takes 3 months we cannot wait for that long(even though there is one permanent stall with ICICI rep.), so you will have to pay in cash, later when the cash settlement would be done from their side we will return you back. We agreed.


The Dr. made proposed bill of around 35k, ICICI agreed 18k immediately remaining they said would be without any worry would be settled when the bill is presented. we proceeded with the surgery.


After 1 week we received 18k for remaining 17k we send them bills report and the 1 page claim for we got the confirmation of the doc reception from ICICI Hyderabad. We received no response for next 2 weeks we inquired back they said 4 page claim required along with additional reports. We said we already have the confirmation of the doc reception, they said they need 4 page form you have send 1 page form, the hopspital rep said 1 page is enough since it is cashless settlement and also done at their affiliated hospi. We were pissed off but it was clarified by the ICICI customer care later why the chaos has happened.


The culprit turns out to be the hospital guys, ICICI customer care said sir we were proceeding with the cashless settle procedure but the hospital finance dept said that the payment has been made hence we froze the process of reimbursing cash to the hospi and are requesting you to re-apply as cash settlement using 4 page form, we followed and got the remaining 17k in 10 days.


I am very skeptic about Mediclaims, but I feel ICICI lombard at least doesnt want to cheat their customers and their customer care service is pretty problem solving by nature.


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