BRIJESHMESAHARA
New member
- Policy Name
- 2890/00058921/000/04
- Company Name
- Chola MS General Insurance Co Ltd
- Customer Care Number
- 18002089100
- Loss Amount
- 18000
- Ratings
- Opposite Party Address
- Chola MS General Insurance Co Ltd
Dear Sir/Madam,
I am writing to lodge a grievance regarding the rejection of my health insurance claim by Chola MS General Insurance.
Details:
My claim was rejected on the grounds that the hospital where treatment was taken is an “excluded hospital.” However, I was never provided any prior information about this exclusion at the time of policy issuance. As a policyholder, I had no knowledge that this hospital was blacklisted.
The rejection is unfair because:
I kindly request the IRDAI to direct the insurer to:
Kindly do the needful at the earliest.
I am writing to lodge a grievance regarding the rejection of my health insurance claim by Chola MS General Insurance.
Details:
- Policy Number: 2890/00058921/000/04
- Company Name: Chola MS General Insurance
- Claim Number: 2890100276
- Name of Insured: Brijeshkumar Mahendrakumar Patel
- Hospital: Baby Care Children Hospital, Ta: Unjha, District: Mehsana 384170
My claim was rejected on the grounds that the hospital where treatment was taken is an “excluded hospital.” However, I was never provided any prior information about this exclusion at the time of policy issuance. As a policyholder, I had no knowledge that this hospital was blacklisted.
The rejection is unfair because:
- The insurer failed to disclose the list of excluded hospitals transparently.
- The patient required urgent child care treatment, and denying claim on such grounds causes severe hardship.
- No Fault of Policyholder: The decision to exclude a hospital is entirely at the discretion of the insurer. As a customer, I have no role in this decision. Hence, penalizing me for choosing a hospital without being adequately informed is unfair and against the principles of natural justice.
- Emergency / Child Care Treatment: Since this treatment involved a child and urgent medical care, the choice of hospital was made based on availability and immediate requirement. In such cases, denial of the claim causes undue hardship to the insured family.
I kindly request the IRDAI to direct the insurer to:
- Reconsider and process my claim fairly.
Kindly do the needful at the earliest.