Dear IRDA Team,
Kindly register my complain against the Apollo Munich Policy No- 110102/11051/1000248937-01
Thnx & Regards
Nitesh Kumar Sharma
+91-9871344288
---------- Forwarded message ----------
From: grievance <grievance@apollomunichinsurance.com>
Date: Tue, Jun 17, 2014 at 11:46 PM
Subject: RE: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
To: "nitesh.1982sharma@gmail.com"<nitesh.1982sharma@gmail.com>
Dear Mr. Sharma,
Greetings from Apollo Munich.
With reference to your below concern, we would like to assure you that we have reviewed the case in detail basis the information/documents made available to us.
It is important to mention that we have received your application form No. 1100508953 for coverage basis which the Policy No. 1000248937 was issued . The questions pertaining to the medical history of the member were answered in negative which should have been answered otherwise .
Submission of all material information truthfully, correctly and completely by the proposer is essential for taking appropriate decision on acceptance/rejection of an application made for insurance.
However, considering your long association with us and basis the details shared by you , we have allowed the policy to be continued .
Further, we regret to inform you that we have not established any fresh ground to consider your request to cancel the policy with refund of premium . Also we are constraint to maintain our stand on repudiation of claim as the same falls under the waiting period of 3 years.
For any further assistance, please feel free to write back to us or reach us on our Helpline number: 1800-102-0333
Thanks & Regards,
Narender Singh Bisht
Asst.Manager ( Grievance Redressal Cell )
Apollo Munich Health Insurance Company Limited
10th Floor, Building No.10, Tower B,
DLF Cyber City, DLF City Phase-2,
Gurgaon-122002, Haryana, INDIA.
From: Padmesh Nair
Sent: Saturday, June 14, 2014 8:07 PM
To: grievance; Vishamjeet Khokher
Subject: Fwd: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
Sent from my iPhone
Begin forwarded message:
From: "Nitesh Sharma"<nitesh.1982sharma@gmail.com>
To: "complaints@irda.gov.in"<complaints@irda.gov.in>, "insombahd@rediffmail.com"<insombahd@rediffmail.com>, "bimalokpalbhopal@airtelbroadband.in"<bimalokpalbhopal@airtelbroadband.in>, "ioobbsr@dataone.in"<ioobbsr@dataone.in>, "ombchd@yahoo.co.in"<ombchd@yahoo.co.in>, "insombud@md4.vsnl.net.in"<insombud@md4.vsnl.net.in>, "iobdelraj@rediffmail.com"<iobdelraj@rediffmail.com>, "ombudsmanghy@rediffmail.com"<ombudsmanghy@rediffmail.com>, "insombudhyd@gmail.com"<insombudhyd@gmail.com>, "iombkol@vsnl.net"<iombkol@vsnl.net>, "ombudsman@vsnl.net"<ombudsman@vsnl.net>, "inscoun@gmail.com"<inscoun@gmail.com>, "ins.omb@rediffmail.com"<ins.omb@rediffmail.com>
Cc: "preauth"<preauth@apollomunichinsurance.com>, "customer service"<customerservice@apollomunichinsurance.com>, "Antony Jacob"<Antony.Jacob@apollomunichinsurance.com>, "Krishnan.Ramachandran@apollomunichinsurance.com"<Krishnan.Ramachandran@apollomunichinsurance.com>, "Aashish Sethi"<aashish.sethi@apollomunichinsurance.com>, "Latha Nair"<latha.nair@apollomunichinsurance.com>, "Ankur Kharbanda"<ankur.kharbanda@apollomunichinsurance.com>, "Shamik Banerjee"<shamik.banerjee@apollomunichinsurance.com>, "Suraj Mishra"<suraj.mishra@apollomunichinsurance.com>, "Samaksh Gupta"<samaksh.gupta@apollomunichinsurance.com>, "Vaibhav L. Sethia"<vaibhav.sethia@apollomunichinsurance.com>, "Sudheer.Devulapally@apollomunichinsurance.com"<Sudheer.Devulapally@apollomunichinsurance.com>, "Mukesh.Kumar@apollomunichinsurance.com"<Mukesh.Kumar@apollomunichinsurance.com>, "Sumit Mukherjee"<sumit.mukherjee@apollomunichinsurance.com>, "Parul Chatterjee"<parul.chatterjee@apollomunichinsurance.com>, "RamKr.Shukla@apollomunichinsurance.com"<RamKr.Shukla@apollomunichinsurance.com>, "Dr. Bhabatosh Mishra"<bhabatosh.mishra@apollomunichinsurance.com>, "Reena Gomes"<reena.gomes@apollomunichinsurance.com>, "Richa Chugh"<richa.chugh@apollomunichinsurance.com>, "Sanjay Manaktala"<sanjay.manaktala@apollomunichinsurance.com>, "Rajagopal Rudraraju"<rajagopal.rudraraju@apollomunichinsurance.com>, "Dr Surya Prakash"<surya.prakash@apollomunichinsurance.com>, "Padmesh Nair"<padmesh.nair@apollomunichinsurance.com>, "Dr.Basant Kumar"<basant.kumar@apollomunichinsurance.com>, "shakti.bhise@apollomunichinsurance.com"<shakti.bhise@apollomunichinsurance.com>, "ankush.mote@apollomunichinsurance.com"<ankush.mote@apollomunichinsurance.com>, "kishore paliwal"<kishore.paliwal@apollomunichinsurance.com>, "Pfizer"<pfizer@apollomunichinsurance.com>, "A Asir Backia Singh"<asir.singh@apollomunichinsurance.com>, "HR"<hr@apollomunichinsurance.com>, "biswabandhu.naug@apollomunichinsurance.com"<biswabandhu.naug@apollomunichinsurance.com>, "umesh.dahal@uhcpindia.com"<umesh.dahal@uhcpindia.com>, "network.services@uhcindia.com"<network.services@uhcindia.com>, "M Sujana Latha"<sujana.latha@apollomunichinsurance.com>, "Shyamveer Singh"<shyamveer.singh@apollomunichinsurance.com>, "Sujit.waghmare@apollomunichinsurance.com"<Sujit.waghmare@apollomunichinsurance.com>, "Ranjeet.ahiwale@apollomunichinsurance.com"<Ranjeet.ahiwale@apollomunichinsurance.com>, "Shivaji.tuppekar@apollomunichinsurance.com"<Shivaji.tuppekar@apollomunichinsurance.com>, "delicia.jones"<delicia.jones@apollomunichinsurance.com>
Subject: Fwd: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
Dear All,
Greetings of the day……
First tell me why we choose Health Insurance, for getting my risks cover. But is there was any insurance who can save me from Insurance Company(Apollo Munich Health Insurance Company).
Three years back dt.24.10.2011, I have taken an health policy no- 110102/11051/1000248937-01 (complete family cover) from Apollo Munich with premium of Rs. 7786/- annually.
Till now I have paid three premium & never taken any claim, but last month due to heavy pain in my stomach I have admitted to Metro Hospital-Delhi & applied for cashless but after my application Apollo Munich starts searching the reason that how they can reject the case.
At last they found the same which I haven’t searched in last 3years, Note: I am an diabetic patient, 3yr back when I have booked an policy at that time I am not aware that sugar patient can not apply for the same policy. In 2005, my operation has been done for pancreatitis in Max Hospital , whose report I have been submitted to Apollo Munich agent, you can check the same has been shown in below mention picture(Proposal Form). And you are very much aware that who was operated for pancreatitis, the same patient will suffers with diabetic automatically.
[cid:image001.png@01CF87E2.8B5D9B40]
In my case agent or x-branch manager done an alteration on my Max Hospital’s discharge summary & hide the diabetic but Apollo Munich not verified that if customer is suffering from pancreatitis operation then they can verify is customer is suffering from diabetic, but they are getting the premium so they decided they we can reject the same case at claim time(eat the premium now). For eating premium & not giving claim they have make an policy that do not verify originals of the customer, ask for the same at the claim time and reject the claim…..
Note: In below mention picture of Proposal Form (6 Section A vii) they have shown Diabetes N N N N & (6 Section B xvii) Taken Surgery N N N N. In the same form they have mention about discharge summary also, Kindly confirm this all was fraud this policy can’t be booked. Miss commitments to me & taken premium + booked policy.
[cid:image002.png@01CF87ED.BB172990]
Infact after my claim they have send me the policy cancellation letter also, but now they are giving different-different statements that your policy is activated & you are suffering from pre-existing disease so your claim has been declined. Even they haven’t identify that now the customer is admitted with different cause.
In between I have met with Mr. Sachin Sharma(Brach Manager-Noida) & discussed regarding the same. After that he commits that we will refund the total paid premium amount after approval(for more detail go through trail mail). He also told me that this all fraud has been done by Mr. Sanjeev Kumar Sharma (X-Branch Manager, Noida) & I am not only the customer who was suffers, he had done so may frauds & he(Mr.Sachin) is bearing for the same. For making sales & completing targets he booked some policy’s with done alteration on date of birth’s. (Whole system is fraud)
But I want to say if I was wrong then after paying 3yr premium amount Rs. 23000/- (approx.) I have submitted cashless claim for amount Rs.30000/-(approx.), you all can identify by this also who is covered for sum assured 2lac he is claimed for approx. amount how much he paid as premium in last three years.
Even the behaviour of Grievance is very poor, they are thinking how can say no to customer.
At last I am suffers & repeating my first line is any policy who can save me from Insurance Company’s?
Thnx & Regards
Nitesh Kumar Sharma
+91-9871344288
Policy No- 110102/11051/1000248937-01
---------- Forwarded message ----------
From: grievance <grievance@apollomunichinsurance.com<mailto:grievance@apollomunichinsurance.com>>
Date: Mon, Jun 9, 2014 at 6:14 PM
Subject: RE: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
To: Nitesh Sharma <nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>>
Dear Mr. Sharma,
Greetings from Apollo Munich.
In continuation to our earlier communication, we would like to inform you that basis the details shared by you we have re-evaluated the case and have decided to let the policy continue as per existing terms and conditions .
Hence the claim will be reviewed again and the final decision on the admissibility of the claim will be communicated to you accordingly.
Request for your patience during the processing time.
For any further assistance, please feel free to write back to us or reach us on our Helpline number: 1800-102-0333.
We candidly submit above resolution against your complaint under clause 6d). You may acknowledge the receipt of this mail and confirm about the closure of the case.
We shall regard the complaint as closed if we do not receive a reply within 8 weeks from the date of receipt of response by the insured /policyholder. Please refer the Policy Wordings and /or visit our website www.apollomunichinsurance.com<http://www.apollomunichinsurance.com/> to know the “Grievance Redressal Procedure”.
Thanks & Regards,
Narender Singh Bisht
Asst.Manager ( Grievance Redressal Cell )
Apollo Munich Health Insurance Company Limited
10th Floor, Building No.10, Tower B,
DLF Cyber City, DLF City Phase-2,
Gurgaon-122002, Haryana, INDIA.
---------- Forwarded message ----------
From: Nitesh Sharma <nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>>
Date: Fri, Jun 6, 2014 at 1:49 PM
Subject: Re: As per our meeting we have discuss on existing Health Policy No. 110102/11051/1000248937
To: Sachin Sharma <sachin.sharma@apollomunichinsurance.com<mailto:sachin.sharma@apollomunichinsurance.com>>
Dear Mr.Sachin,
Kindly read my last mail properly in which I have clearly mention that you are putting the requested mail to finance department regarding the same.
Yes, agreed with you haven’t given any kind of commitment regarding any refund of complete paid premium but you told me that you will put the mail to finance team for an approval.
Secondly regarding the handwriting on Proposal Form was of agent only, in the same reference you have an written statement letter from agent in which clearly mention that he have filled the same application form & he have handover the complete documents to Mr. Sanjeev Kumar Sharma, also he confirms that whatever the wrong has been done on Mr. Sanjeev Kumar Sharma’s part.
If it is possible you can share the same letter with me also.
Kindly confirm once you receive any revert from finance team?
Thnx & Regards
Nitesh Kumar Sharma
+91-9871344288
On Thu, Jun 5, 2014 at 8:23 PM, Sachin Sharma <sachin.sharma@apollomunichinsurance.com<mailto:sachin.sharma@apollomunichinsurance.com>> wrote:
Dear Nitesh ji
No commitment of any sort had been given to you by me
Rest regarding handwriting on PF we have discussed that if as a client you have not filled than it may be either agent or our ex-employee, in which our ex-employee (Sanjeev kumar Sharma) is non-traceable.
Thanks & Regards
Sachin Sharma
Senior Manager- Agency (Noida,East Delhi & U.P-1)
Apollo Munich Health Insurance Co. Ltd.
3rd Floor,N-23,Sector-18,
Noida (U.P): 201301.
Tel - +91 9958791174, +91-120-4282629
From: Nitesh Sharma [mailto:nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>]
Sent: Thursday, June 05, 2014 7:41 PM
To: Sachin Sharma
Subject: As per our meeting we have discuss on existing Health Policy No. 110102/11051/1000248937
Dear Mr. Sachin Sharma,
Greetings of the day…
It’s a great feeling to have a meeting with you today.
As per our meeting we have discuss on existing Health Policy No. 110102/11051/1000248937 in my name & result of the same meeting is that you will put an request mail for an approval to finance team for refund of complete premium which I have paid in last 3years.
Also you have confirms that your agent (80092037) who have booked my policy have given you an written statement that he/she have filled the same application form, also he/she confirms that all this wrong is done by Mr.S.k.Sharma (X-Branch Manager) not by him/her. And according to you Mr.S.k.Sharma is not traceable or contactable.
Thanking you for your all this support & expecting for you reply after 2-3days, once you will received an approval from finance team.
Regards
Nitesh Sharma
+91-9871344288
The information in this electronic mail including any attachments is confidential in nature and may be legally privileged and is for the exclusive use of the intended recipient(s). Any disclosure, review or reliance by others or copying or distribution or forwarding of any or all of the contents in this message and attachments or taking any action based on it, is strictly prohibited. If you are not the intended recipient(s), please contact the sender by email and delete all the copies. The recipient(s) acknowledges that the contents of the e-mail and the attachments may not necessarily represent the views and policies of Apollo Munich Health Insurance Company Limited. Before opening any attachment, please scan for any viruses and the defects. Apollo Munich Health Insurance Company Limited is not responsible for the damage, if any, caused by a virus or alteration of the e-mail by a third party or otherwise
From: grievance
Sent: Thursday, June 05, 2014 12:06 AM
To: 'Nitesh Sharma'
Subject: RE: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
Dear Mr. Sharma,
Greetings from Apollo Munich.
In continuation to our earlier communication, we would like to inform you that we have evaluated the case with complete due diligence basis the information/documents made available to us and wish to share the following observations:
That the application form which is the basis of the policy, that was signed and submitted to us, had all relevant questions (Question no. 6 – Medical and Lifestyle Information) answered in negatives. Information provided therein were the basis of us issuing said policy to you. Refer the attached Application form No 1100508953.
Basis the submitted discharge summary dated 20-Oct-2006, we note that the member is a known case of diabetes Mellitus, however the said medical condition was not made available to us in the application form submitted to us on 24-Oct-2011. ( Please find attached a copy of discharge summary for your reference).
We would like to share that the medical condition of diabetes Mellitus falls under outright rejection criteria under the product opted by you. Had this information related to medical history been declared in the application form, the proposal with regard to the member would not have been issued in the beginning.
In view of above noted discrepancy, we would request you to please provide us the clarification regarding the same along with the first prescription and other medical documents pertaining to the diabetes mellitus.
On receipt of the same we shall be able to evaluate and submit our final decision on admissibility of claim as per policy terms and conditions.
For any further assistance, please feel free to write back to us or reach us on our Helpline number: 1800-102-0333.
We candidly submit above resolution against your complaint under clause 6d). You may acknowledge the receipt of this mail and confirm about the closure of the case.
We shall regard the complaint as closed if we do not receive a reply within 8 weeks from the date of receipt of response by the insured /policyholder. Please refer the Policy Wordings and /or visit our website www.apollomunichinsurance.com<http://www.apollomunichinsurance.com/> to know the “Grievance Redressal Procedure”.
Thanks & Regards,
Narender Singh Bisht
Asst.Manager ( Grievance Redressal Cell )
Apollo Munich Health Insurance Company Limited
10th Floor, Building No.10, Tower B,
DLF Cyber City, DLF City Phase-2,
Gurgaon-122002, Haryana, INDIA.
From: grievance
Sent: Wednesday, May 28, 2014 7:01 PM
To: Nitesh Sharma
Subject: RE: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
Dear Mr. Sharma,
Greetings from Apollo Munich.
We would like to state that we always want to submit a fair resolution to our customers and for the same we require to understand the related facts and information before arriving at a final decision. Hence, the activity at times consumes more than expected time.
We assure you an appropriate response on the same by 04th June 2014.
Request for your patience during the processing time.
For further assistance, please feel free to write back to us or call us on our Helpline number: 1800-102-0333.
Thanks & Regards,
Vivek Manchanda
Grievance Redressal Cell
Apollo Munich Health Insurance Company Limited
10th Floor, Building No.10, Tower B,
DLF Cyber City, DLF City Phase-2,
Gurgaon-122002, Haryana
Website - http://www.apollomunichinsurance.com
From: grievance
Sent: Tuesday, May 27, 2014 10:45 PM
To: Nitesh Sharma
Subject: RE: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
Dear Mr. Sharma,
Greetings from Apollo Munich.
We would like to inform that as an organization we always endeavor to review all claims fairly and in the interests of all our customers. Whenever a claim is received by us, we access the admissibility basis a comprehensive review of inputs received from the customer/ hospital and information available from the submitted documents before arriving at the decision. All claims are processed as per the merits of the case subject to policy terms and conditions.
With reference to your mail below addressed to CEO office, we would like to inform you that we have reviewed your cashless claim(127725) basis the information/documents made available to us.
We regret to inform you that the cashless facility cannot be extended.
Further we are reviewing the case in totality and will share our detailed response on the subject matter before the end of 28th May 2014.
For further assistance, please feel free to write back to us or call us on our Helpline number: 1800-102-0333.
Thanks & Regards,
Vivek Manchanda
Grievance Redressal Cell
Apollo Munich Health Insurance Company Limited
10th Floor, Building No.10, Tower B,
DLF Cyber City, DLF City Phase-2,
Gurgaon-122002, Haryana
Website - http://www.apollomunichinsurance.com
From: delicia.jones
Sent: Tuesday, May 27, 2014 4:57 PM
To: Nitesh Sharma
Cc: grievance
Subject: RE: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
Dear Mr. Sharma,
This is to acknowledge receipt of your concern received in the office of the CEO on 27th May, 2014.
Please note that we have requested the Grievance Head to look into the matter and have someone from his team revert to you before the end of 28th May 2014, with a clarification.
We appreciate your patience in the meantime.
Regards,
Delicia Jones
Executive Assistant to the CEO
Apollo Munich Health Insurance
www.apollomunichinsurance.com<http://www.apollomunichinsurance.com/>
From: Nitesh Sharma [mailto:nitesh.1982sharma@gmail.com]
Sent: 27 May 2014 16:43
To: delicia.jones
Cc: ankur.tyagi@y7mail.com<mailto:ankur.tyagi@y7mail.com>
Subject: Fwd: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
Dear Delicia Jones,
It's very urgent kindly followup the same & revert me on +91-9871344288.
regards
Nitesh Sharma
---------- Forwarded message ----------
From: Antony Jacob <Antony.Jacob@apollomunichinsurance.com<mailto:Antony.Jacob@apollomunichinsurance.com>>
Date: Tue, May 27, 2014 at 4:38 PM
Subject: Automatic reply: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
To: Nitesh Sharma <nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>>
Hi,
Thank you for your message. I am out of office and will return on 3rd June 2014. I will be checking emails during this time intermittently and will respond as soon as possible. If urgent please contact my assistant, Delicia Jones on her email : delicia.jones@apollomunichinsurance.com<mailto:delicia.jones@apollomunichinsurance.com>.
Thank you,
Kind Regards,
Antony Jacob
The information in this electronic mail including any attachments is confidential in nature and may be legally privileged and is for the exclusive use of the intended recipient(s). Any disclosure, review or reliance by others or copying or distribution or forwarding of any or all of the contents in this message and attachments or taking any action based on it, is strictly prohibited. If you are not the intended recipient(s), please contact the sender by email and delete all the copies. The recipient(s) acknowledges that the contents of the e-mail and the attachments may not necessarily represent the views and policies of Apollo Munich Health Insurance Company Limited. Before opening any attachment, please scan for any viruses and the defects. Apollo Munich Health Insurance Company Limited is not responsible for the damage, if any, caused by a virus or alteration of the e-mail by a third party or otherwise
---------- Forwarded message ----------
From: Nitesh Sharma <nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>>
Date: Tue, May 27, 2014 at 4:39 PM
Subject: Fwd: Giving regular premium from last 3Yrs & now when i require it no use of that-- Policy No- 110102/11051/1000248937-01
To: preauth@apollomunichinsurance.com<mailto:preauth@apollomunichinsurance.com>, customerservice@apollomunichinsurance.com<mailto:customerservice@apollomunichinsurance.com>, antony.jacob@apollomunichinsurance.com<mailto:antony.jacob@apollomunichinsurance.com>
Cc: Krishnan.Ramachandran@apollomunichinsurance.com<mailto:Krishnan.Ramachandran@apollomunichinsurance.com>, Aashish.Sethi@apollomunichinsurance.com<mailto:Aashish.Sethi@apollomunichinsurance.com>, Latha.Nair@apollomunichinsurance.com<mailto:Latha.Nair@apollomunichinsurance.com>, Ankur.Kharbanda@apollomunichinsurance.com<mailto:Ankur.Kharbanda@apollomunichinsurance.com>, Shamik.Banerjee@apollomunichinsurance.com<mailto:Shamik.Banerjee@apollomunichinsurance.com>, Suraj.Mishra@apollomunichinsurance.com<mailto:Suraj.Mishra@apollomunichinsurance.com>, Samaksh.Gupta@apollomunichinsurance.com<mailto:Samaksh.Gupta@apollomunichinsurance.com>, Vaibhav.Sethia@apollomunichinsurance.com<mailto:Vaibhav.Sethia@apollomunichinsurance.com>, Sudheer.Devulapally@apollomunichinsurance.com<mailto:Sudheer.Devulapally@apollomunichinsurance.com>, Mukesh.Kumar@apollomunichinsurance.com<mailto:Mukesh.Kumar@apollomunichinsurance.com>, Sumit.Mukherjee@apollomunichinsurance.com<mailto:Sumit.Mukherjee@apollomunichinsurance.com>, Parul.Chatterjee@apollomunichinsurance.com<mailto:Parul.Chatterjee@apollomunichinsurance.com>, RamKr.Shukla@apollomunichinsurance.com<mailto:RamKr.Shukla@apollomunichinsurance.com>, Bhabatosh.Mishra@apollomunichinsurance.com<mailto:Bhabatosh.Mishra@apollomunichinsurance.com>, Reena.Gomes@apollomunichinsurance.com<mailto:Reena.Gomes@apollomunichinsurance.com>, Richa.Chugh@apollomunichinsurance.com<mailto:Richa.Chugh@apollomunichinsurance.com>, sanjay.manaktala@apollomunichinsurance.com<mailto:sanjay.manaktala@apollomunichinsurance.com>, Rajagopal.Rudraraju@apollomunichinsurance.com<mailto:Rajagopal.Rudraraju@apollomunichinsurance.com>, Surya.Prakash@apollomunichinsurance.com<mailto:Surya.Prakash@apollomunichinsurance.com>, Padmesh.Nair@apollomunichinsurance.com<mailto:Padmesh.Nair@apollomunichinsurance.com>, Basant.Kumar@apollomunichinsurance.com<mailto:Basant.Kumar@apollomunichinsurance.com>, shakti.bhise@apollomunichinsurance.com<mailto:shakti.bhise@apollomunichinsurance.com>, ankush.mote@apollomunichinsurance.com<mailto:ankush.mote@apollomunichinsurance.com>, kishore.paliwal@apollomunichinsurance.com<mailto:kishore.paliwal@apollomunichinsurance.com>, pfizer@apollomunichinsurance.com<mailto:pfizer@apollomunichinsurance.com>, asir.singh@apollomunichinsurance.com<mailto:asir.singh@apollomunichinsurance.com>, hr@apollomunichinsurance.com<mailto:hr@apollomunichinsurance.com>, biswabandhu.naug@apollomunichinsurance.com<mailto:biswabandhu.naug@apollomunichinsurance.com>, umesh.dahal@uhcpindia.com<mailto:umesh.dahal@uhcpindia.com>, network.services@uhcindia.com<mailto:network.services@uhcindia.com>, sujana.latha@apollomunichinsurance.com<mailto:sujana.latha@apollomunichinsurance.com>, shyamveer.singh@apollomunichinsurance.com<mailto:shyamveer.singh@apollomunichinsurance.com>, Sujit.waghmare@apollomunichinsurance.com<mailto:Sujit.waghmare@apollomunichinsurance.com>, Ranjeet.ahiwale@apollomunichinsurance.com<mailto:Ranjeet.ahiwale@apollomunichinsurance.com>, Shivaji.tuppekar@apollomunichinsurance.com<mailto:Shivaji.tuppekar@apollomunichinsurance.com>, claimscare@apollomunichinsurance.com<mailto:claimscare@apollomunichinsurance.com>, ankur.tyagi@y7mail.com<mailto:ankur.tyagi@y7mail.com>, ankittyagi1984@gmail.com<mailto:ankittyagi1984@gmail.com>
To,
Shri Antony Jacob
Chief Executive Officer
Apollo Munich Health Insurance Company Ltd.
10th Floor, Tower-B, Bldg.No.10
DLF Cyber City, DLF City Phase II
GURGAON 122 002
Tel.No.0124-4584101 / 4548333 (B)
Fax No.0124-4584111
E-mail: antony.jacob@apollomunichinsurance.com<mailto:antony.jacob@apollomunichinsurance.com>
This is to inform you that I purchase the Apollo Munich policy last three years back. I am paying premium regular on time from last three years. I have never taken any claim in last three years. Today I am hospitalized for the first time & my case is rejected saying that you do not have the declaration for my previous disease updated in your system. Do you think it is my fault that your system is not updated. I have provided proposal form to Mr. Dev in TPA in which I have clearly mentioned about my previous disease & I have also provided my Max discharge summary for the year 2006 at the time of insurance. Insurance agent committed me that I will get all the claims related to the same, otherwise why I will go with the same. Currently I am admitted at Metro Hospital Preet vihar under observation of Dr. Rajat Saxena. Last evening Hospital has informed me to discharge but my case is rejected & now I have provided additional documents to TPA to approve my case but do you think I have to wait for another 24 hours for this. I have not received any response from them till yet. Do you think I am paying premium from last three years for this day. Do you think we will continue our relation like this great service. Please look into this matter ASAP.
I am only waiting for your approval so I can get discharge…….
Mr Nitesh Kumar Sharma
Policy Number : 110102/11051/1000248937-01
Contact No: 9871344288
Pre Auth ID: 127725
Thanks in Advance.
Regards,
Nitesh Kumar Sharma
+91-9871344288
---------- Forwarded message ----------
From: customer service <customerservice@apollomunichinsurance.com<mailto:customerservice@apollomunichinsurance.com>>
Date: Tue, May 27, 2014 at 1:29 PM
Subject: Proposal form As Per Your Request (Policy no. :1000248937-02)
To: "nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>"<nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>>
Dear Mr. Nitesh ,
Thank You for choosing to insure your health with Apollo Munich Health Insurance, the expert in healthcare and insurance.
With reference to your telecon with one of our executive on the toll free number, please find enclosed proposal form as per your request.
In case you need further assistance, please feel free to write us.
“We request you to share with us your experience & valuable feedback on how your query/request was handled by us. This would help us serve you better in future.“
We look forward to providing you uncomplicated health insurance services.
Thanks & Regards,
Priyanka Sharma,
Customer Relationship Management Team
Apollo Munich Health Insurance Company Limited
10th Floor, Building No.10, Tower B,
DLF Cyber City, DLF City Phase-2,
Gurgaon-122002, Haryana, INDIA.
Website - http://www.apollomunichinsurance.com
Twitter - Follow us @apollomunichins
Join our Facebook fan page: http://www.facebook.com/ApolloMunichHealthinsurance
[Description: Description: cid:image001.jpg@01CC3FB2.430DFAE0]
Please don't print this E-Mail unless you really need to. This Will Preserve Trees.
The information in this electronic mail including any attachments is confidential in nature and may be legally privileged and is for the exclusive use of the intended recipient(s). Any disclosure, review or reliance by others or copying or distribution or forwarding of any or all of the contents in this message and attachments or taking any action based on it, is strictly prohibited. If you are not the intended recipient(s), please contact the sender by email and delete all the copies. The recipient(s) acknowledges that the contents of the e-mail and the attachments may not necessarily represent the views and policies of Apollo Munich Health Insurance Company Limited. Before opening any attachment, please scan for any viruses and the defects. Apollo Munich Health Insurance Company Limited is not responsible for the damage, if any, caused by a virus or alteration of the e-mail by a third party or otherwise
---------- Forwarded message ----------
From: Nitesh Sharma <nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>>
Date: Tue, May 27, 2014 at 12:31 PM
Subject: Re: Repudiation Letter Pre-authorization ID : 127725 of Nitesh Kumar Sharma
To: preauth@apollomunichinsurance.com<mailto:preauth@apollomunichinsurance.com>
Cc: customerservice@apollomunichinsurance.com<mailto:customerservice@apollomunichinsurance.com>
Dear Sir/Madam,
We refer to your mail received today.
I am really surprised to see that my cashless request is denied by your team.
I wish to inform you that I have already declared by pre & post health statements in the proposal form once I got the health insurance policy from Apollomunich.
I have already submitted by Discharge Summary of my Surgery to Apollo Munich. As I have confirmed with the customer care at Apollo Munich and they have confirmed that they have my Discharge report in their records.
I request you to contact with the Apollo Munich 'customerservice@apollomunichinsurance.com<mailto:customerservice@apollomunichinsurance.com>' immediately.
I am a your regular policy holder and I need your kind support.
I request you please do not overlook my case as I have already submitted desired documents to Apollo Munich and I have not played any hide & seek game at the time of policy.
Please contact the concern persons and open my case immediate. I am at present admitted with Metro Hospital, Preet Vihar, New Delhi-1100095 under the treatment of Dr. Rajat Sexana. I would like to get the discharged from this hospital today itself so I once again request you to take the matter at priority under intimation to me by phone/sms/mail.
Your kind efforts and assistance shall highly thankful.
I look forward to see your kind support as a needy person.
Best Regards
Nitesh Kumar Sharma
Mobile No. 9811631291
---------- Forwarded message ----------
From: <claimscare@apollomunichinsurance.com<mailto:claimscare@apollomunichinsurance.com>>
Date: Mon, May 26, 2014 at 2:54 PM
Subject: Query Letter for Pre-authorization ID:127725 of Nitesh Kumar Sharma
To: nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>
Dear Sir/Madam,
We take this opportunity to thank you for theservices being rendered to our valued customer.
We are processing above mentioned cashless request and are unable to arrive at a decision of admissibility as we require additional documents. Kindly submit the following documents at the earliest:
Please provide TDC for the duration and etiogogy of chronic pancreatitis and past treatment papers of laparotomy and pancreatic jejunostomy.
Kindly Submit above mentioned documents as soon as possible so that we can process the cashless request. In case we do not receive any response from you we will be constrained to proceed with our decision based on available documents.
In case you believe that we have overlooked any material fact or circumstances, kindly let us know for evalution by writing to customerservice@apollomunichinsurance.com<mailto:customerservice@apollomunichinsurance.com> or you can also call us on our toll free number 18001020333. Kindly quote the Pre-authorization ID in all communications for easy identification of the cashless request.
Yours Sincerely
Authorized Signatory,
Disclaimer : This is an auto generated mail. Do Not Reply.
---------- Forwarded message ----------
From: <claimscare@apollomunichinsurance.com<mailto:claimscare@apollomunichinsurance.com>>
Date: Tue, May 20, 2014 at 2:02 PM
Subject: P.A. ID : 127725 ::: Nitesh Kumar Sharma
To: nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>
Name of the Insured :
Nitesh Kumar Sharma
Name of the Patient :
Nitesh Kumar Sharma
Dear Customer,
The Cashless Request received from Metro Hospital And Cancer Institute, 21, Community Centre, Preet Vihar, Delhi, Delhi, NEW DELHI, Delhi *-110092 for admission of Nitesh Kumar Sharma, UHIDNO:10002593046 is registered with ID No. 127725 and is under process.
It is only intimation of registration of your Request. Further status will be updated soon.
From
Apollo Munich Health Insurance Co. Ltd.,
Disclaimer : This is an auto generated mail. Do Not Reply.
---------- Forwarded message ----------
From: <claimscare@apollomunichinsurance.com<mailto:claimscare@apollomunichinsurance.com>>
Date: Tue, May 20, 2014 at 4:18 PM
Subject: P.A. ID : 127725 ::: Nitesh Kumar Sharma
To: nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>
Name of the Insured :
Nitesh Kumar Sharma
Name of the Patient :
Nitesh Kumar Sharma
Dear Customer,
Ref. Cashless RequestID 127725, UHIDNO:10002593046 of Patient
Your cashless request is extended for the amount of Rs.8500/- with conditions mentioned below.
Covered for active medical management requiring hospitalization. Investigations and treatment not related to the ailment authorized for will not be covered. Any additional finding or investigation recommended, will have to intimated and consent/approval taken prior to the investigation/intervention. Will not be covered if intimated during the time of discharge.
Total amount authorized against this cashless request is Rs.8500/-
Please check discharge summary and sign on the main bill and the claim form at the time of discharge
From
Apollo Munich Health Insurance Co. Ltd.,
We would be happy to hear from you to serve you better. Please give us your valuable feedback by filling the questionnaire. To access the form please click this link.<https://www.research.net/s/apollomunich_cashless_feedback?c=127725>
Disclaimer : This is an auto generated mail. Do Not Reply.
---------- Forwarded message ----------
From: <claimscare@apollomunichinsurance.com<mailto:claimscare@apollomunichinsurance.com>>
Date: Tue, May 20, 2014 at 2:37 PM
Subject: Query Letter for Pre-authorization ID:127725 of Nitesh Kumar Sharma
To: nitesh.1982sharma@gmail.com<mailto:nitesh.1982sharma@gmail.com>
Dear Sir/Madam,
We take this opportunity to thank you for theservices being rendered to our valued customer.
We are processing above mentioned cashless request and are unable to arrive at a decision of admissibility as we require additional documents. Kindly submit the following documents at the earliest:
Pls forward the investigation reports of the patient supporting the diagnosis with the treatment charts.
Kindly Submit above mentioned documents as soon as possible so that we can process the cashless request. In case we do not receive any response from you we will be constrained to proceed with our decision based on available documents.
In case you believe that we have overlooked any material fact or circumstances, kindly let us know for evalution by writing to customerservice@apollomunichinsurance.com<mailto:customerservice@apollomunichinsurance.com> or you can also call us on our toll free number 18001020333. Kindly quote the Pre-authorization ID in all communications for easy identification of the cashless request.
Yours Sincerely
Authorized Signatory,
Disclaimer : This is an auto generated mail. Do Not Reply.
The information in this electronic mail including any attachments is confidential in nature and may be legally privileged and is for the exclusive use of the intended recipient(s). Any disclosure, review or reliance by others or copying or distribution or forwarding of any or all of the contents in this message and attachments or taking any action based on it, is strictly prohibited. If you are not the intended recipient(s), please contact the sender by email and delete all the copies. The recipient(s) acknowledges that the contents of the e-mail and the attachments may not necessarily represent the views and policies of Apollo Munich Health Insurance Company Limited. Before opening any attachment, please scan for any viruses and the defects. Apollo Munich Health Insurance Company Limited is not responsible for the damage, if any, caused by a virus or alteration of the e-mail by a third party or otherwise