Apr 22, 2016 12:03 AM
67223 Views
I had applied for a health insurance policy "Health companion" for my mother who is a senior ciitizen.
I truthtfully declared all her preexisting conditions(Diabetes mellitus & Cataract) to the underwriting team, sales team and to the doctor team who had come for carrying out the test.
The medical test was done on 9th April 2016 on a saturday and the reports were shared with maxbupa team by the lab authorized by Maxbupa. On Tuesday morning i.e 13th April I get a call from max bupa team stating that the medical reports for my mother are normal and company has decided to issue the policy without any risk based loading.I was delighted with the prompt response from Maxbupa and considering my good experience with them earlier, it increased my faith in them.The agent sends me a mail on this and lists hypertensive diseases in addition to diabetes mellitus, cataract as a a preexisting ailment for my mother which will not be covered for 3 years.
Also cerebrovascular diseases is listed in the exclusion list.I was surprised as my mother had never suffered from hypertensive and cerebrovascular ailments and neither had she taken any medicines .so I immediately called up my agent and apprised him of my concerns. My agent told me that sir our laboratory has sent a sheet where in he has ticked that your mother is suffering from hypertensive ailment.I got that sheet from my agent and indeed the lab had made a mistake. The agent on hearing my concerns told me to approach the lab directly and ask him to declare on his letter head that he had made a mistake in recording the facts.I immediately called up the lab and apprised them of the mistake that they had committed.They assured me to correct their mistake and submit the apology on their letter head by evening to max bupa team.By evening they had mailed their apology to the max bupa team with a copy to me. On 14th Morning I get a mail(autoreply) from maxbupa team saying that company has decided to levy a risk based loading of 150% for my mother.I was surprised .I again called up my agent and asked him as to what was the matter as only yesterday they had conveyed to me that there will be no loading for my mother as her reports are normal.The agent after seeing the update in his system request me for sometime and assured that he will internally take up the matter.I was assured as upto now I had got a good response from them.Here is where the story takes a ugly turn.
On 19th evening I get a call from my agent saying that the company has removed hypertensive and cerebrovascular diseases from preexisting ailments, however the premium loading of 150% will remain applicable.I started having arguments with him and ask me to justify the grounds on which they have decided to levy such a high loading as her reports are absolutely normal.I also counter him as to how can a company change a stand in a span of 4 days when initially they decide not to levy any loading and later on decide to levy 150% loading.The agent answers me "sir I cannot share the criteria for loading with you.But since you yourselves had declared that your mother was a patient of diabetes so we have decided to levy the loading.So I countered" I think I made a mistake in honestly declaring all my preexisting ailments to you "
On 20th I countered the customer service team on this and argued that the premium that the sales agent conveyed to me on 19th was same as what was conveyed to me on 14th by auto reply mail .so what did the sales agent do all this time?what took him so long to convey this simple message to me?The team was unable to give a convincing reply to this and started beating around the bush
Now listen to the next argument from maxbupa." I countered the customer service that the premium communicated earlier on 14th via autoreply mail(with 150% loading) was considering the fact my mother was suffering from hypertensive ailments.Now since that is removed the the% loading has to come down also.The customer service team tells me "sir loading chaahe 1 disease ho yaa 3 disease ho, same hi rehta hai" Can this be possible?Now imagine a situation where in the insurance company based on your reports observes more than 1 points of adverse medical history.Will they keep the premium same for all the situations, irrespective of your medical ailments?Never.
This erased all my trust on maxbupa and the respect which I had for them. In fact now I am thinking of reviewing my existing policy with them which I have for self and my wife.
subhabrata ray
