The Plight of Taking An Insurance Policy From Religare Health Insurance Company... #religarehealthinsurance

Ladies & Gentleman,

Please please be careful while choosing your Health Insurance Policy.

RELIGARE HEALTH INSURANCE (RHI) is the worst insurance company in the private sector and I substantiate my statement with the horrible experience which I have experienced while my 74 years old mother was hospitalised at Medica Superspecialty Hospital, in Kolkata in the month of September, 2016.

Kindly go thru the entire episode which I have gone thru and I am still fighting for it.

I have written a detail mail to the Ceo, Mr. Anuj Gulati at Religare, but there's no acknowldegment nor a reply...Forget a call from the Sr.Management Team..

Hence I felt that I should inform my fellow members on Linkedin about my horrible experience with Religare Health Insurance and therefore they may be careful if they are planning to buy an insurance policy from Religare Health Insurance.

The Chase which seems like a never ending chase.....

 I got an insurance policy of around 10 lacs for my sr.citizen member of my family, my mom, Mrs.Happy Bose, aged 73 years old  on the 31st December 2015. Just to make you understand that a sr. citizen policy is only given post a mandatory health check up done by Religare Health Insurance Company, to rule out any pre-existing diseases like hypertension, diabetes, etc etc. Mom was declared normal on the parameters and no diseases were detected. I was promptly asked to pay a premium of Rs. 55183 per annum to get her 10 lacs cashless claim coverage. 

In the month of March or April 2016, my mother was complaining of frequent urination which looked like a symptom of Diabetes and we were also noticing her temperament going haywire.

We immediately got her sugar tests done and could figure out a marginal/borderline increase of sugar level and simultaneously was getting her pressures checked on a regular basis for a week which indicated a rise in pressure also. Just to give you a quick background of my mom, she is a super fit person, climbs up & down 3 tiers of floor in a day without any problem, goes for regular walks and does all outside errand works by herself. A Very Self Dependent Person. We wanted to consult a doc but she refused to consult one and instead restricted herself to saltless and sugar-free diet and kept her walks on..

In the month July 2016, her test reports were done once again, and we could again see the borderline increase of sugar levels and this time she was forcibly taken to Dr. Tanmoy Banerjee at Medica Super Speciality Hospital in Kolkata and for the first time the doctor prescribed her to take Diabetes and Hypertension Medicines.

In the month of September 2016, she has fallen sick because of severe dysentery and gastro disorder and initially was administered medicines for the same with consultation over the phone by the Doctor. But it got worsened and she was very very sick and feeble because of passing bowel motions for more than 7-10 times a day. Due to her severe weakness, she had a fall and hurt herself badly. On The Doctor's advice, she was immediately rushed to Medica Hospital in the emergency wing and later was admitted to the hospital under the doctor's consultation. 

In thhe mean time,I was carrying my mom's religare cashless card and immediately submitted all docs including the clinical note from the doc stating the severity of her health and a self-attested statement of mine stating that my mom had diabetes and hypertension since March 2016, much after the policy was bought. I have also given the Doctor's First prescription, dated 25/07/2016 which prescribed medicines of diabetes & hypertension.

To my surprise, my cashless claim got rejected twice even after furnishing all medical documents to the hospital TPA team or to the Religare Cashless team.I got thru Mr. Kewal of Religare Cashless Claims Team and explained him the entire case history and once again have sent him the entire set of documents as asked by him. The Religare team once again denied the claim stating the site of pre-existing disease which is diabetes and hypertension.

Mr. Kewal from Cashless team was extremely callous, & not at all responsible to hand a distress client’s call. While I was speaking to him on the 15th September, evening at 7.45 pm, he once again asked me to send again all the related docs by email to [email protected], which I have submitted to the TPA Department in the early evening. I was told that I will get a revert back in 2 hours time. I waited for a call back from Religare cashless team or from Mr. Kewal, but till date never got a revert back from him.

Just wanna ask... Can't a customer expect a sense of responsibility from the Insurance Claims desk when a person in distress calls up the customer care team??

I was explaining the above case history to Mr. Kewal but instead of listening patiently,he kept on stating that the cashless claim got rejected because of pre-existing disease of hypertension and diabetes. 

I did explain to him that the mentioned two diseases were under medication from July, 2016 and also shared the doc’s first prescription but in vain. He cited the same reasons for the decline.

Sir, I would like to draw your kind attention to the fact that my mother has gone thru the pre-insurance medical check up from Religare and was declared normal by her test parameters before she was offered the Religare Health Insurance Policy. It was the Religare team who declared her fit & normal and then only the policy was issued to her. 

NOW I WOULD LIKE TO KNOW AND UNDERSTAND THE REASONS FOR REJECTING THE CASHLESS CLAIM OF MY MOTHER WHO WAS MEDICALLY DECLARED FIT WITH NO SUCH DISEASE BY YOUR MEDICAL CHECK UP TEAM.

Secondly, my mom’s diseases were diagnosed by Dr. Tanmoy Banerjee since July 2016 and this date is after 7 months post taking the insurance policy. I would like to have detailed explanation from Religare team, on what grounds the cashless team have denied the CASHLESS BENEFIT on my mother’s account when there is no existing of pre-illness history.

Thirdly she was admitted at Medica Hospital for severe Dysentery which is a type of gastroenteritis and not because of any disease which will happen because of diabetes and hypertension. Can you kindly explain the link between the two disease which prompted you to cancel the cashless claim citing the reason " PRE-EXISTING DISEASE"?

 Since October, 2016, I have send all related medical docs to Religare Claims team, not once but thrice and still I receive a mail from the claims department, the docs are not received by them. The funniest part is when I called up the customer service desk on the 21st November, 2016 post sending all the medical records again via mail on the 19th November, the customer service executive Mr. Sumit Chauhan confirms me the receipt of all docs post confirming it with claims department and the same was reconfirmed by his supervisor Mr. Himanshu Ahuja.To add to this, Medica Hospital also confirmed that the hard copy of my mom’s medical records have been picked up by the Religare representative on the 16th November, 2016 from Medica Super speciality Hospital in person. Despite that I receive a mail on the 20th November, 2016, stating that the religare claims team haven’t yet received the docs. Post receiving the mail on the 16th November, 2016, my wife visited Medica Hospital and got all the medical records collected from Medical and I have immediately mailed all the relevant docs ( for the third time) to claims department email id. On 20th November, 1620 hours, I once again get a mail stating that docs not yet received. 

It’s such a horrible experience with Religare and I think one should carefully choose the health insurance and that too for a senior citizen member.

I do not know nor I have a clue of how long do I have to pursue with this….but will surely continue to do so till end.

My appeal to one and all in Lindedin.com..

Please please think not once but thrice before buying a health insurance policy from private insurance players like Religare Health Insurance, specially when you are buying a cover for aged mom or dad.

Thank you for your patience and I hope it will open your eyes before you buy an insurance policy.

Aniruddh A Basu