In the continuation of my previous blog post ‘Broken Promise …’, where I shared my exasperating experience with Aditya Birla Health Insurance, I feel compelled to shed further light on the lack of an escalation matrix in Aditya Birla health insurance and the disheartening ways in which legitimate claims can be rejected. It’s disconcerting how, even with written consent from a doctor regarding the severity of a case, insurance providers find avenues to dismiss claims.

Ways to reject claim

When i had been lured to port our health insurance from Royal Sundaram to Aditya Birla, we were assured that all benefits would remain intact, and there would be no lock-in period. Unfortunately, in the realm of health insurance, promises seem to be mere illusions. Aditya Birla, despite earlier assurances, managed to reject my claim on the grounds that the disease existed before the policy inception, and the specific ailment wasn’t covered due to its association with childbirth.

Endless Queries, Minimal Answers

Upon receiving the rejection, I raised three crucial queries regarding the porting process, the continuity of benefits, and clarification on why the claim for the fibroid disease was denied, when we excluded the expense of baby delivery. Despite escalating these queries to senior authorities, I found myself consistently met with a single paragraph in response from Aditya Birla, each time delivered by a customer support technician rather than a senior representative.

Desperation to Reject Claims

To my dismay, despite repeated attempts to connect with senior personnel at Aditya Birla Health Insurance, the responses remained confined to customer support staff. It became evident that the team’s desperation to reject the claim overshadowed any sincere effort to address genuine concerns. This was further highlighted when hospital deny any contact or inquire from Aditya Birla – exposed the lengths of insensitivity to which the insurance team went to dismiss the claim.

Pursuing Justice

What should have been a time of joy and celebration with my newborn turned into a relentless pursuit of justice against Aditya Birla. Months of back-and-forth communication, continuous frustrations, and unresolved queries have marred what should have been a precious time with my new-born angel. I found myself exceedingly frustrated and decided to cease pursuing the matter. The rejection of my claim amount 1.5 – 1.8 lacs, which amounted to a fraction of my policy limit 10 lacs, highlighted the glaring flaws in the system ran by money greedy mongers.

Concerns for the Future

While I have weathered this storm, my apprehension extends to the millions of clients who place their trust in Aditya Birla Health Insurance, who would soon find that their trust going to be shattered. In email correspondence, the unwavering confidence displayed by the company, coupled with a seemingly elusive rule book, raises concerns about transparency and customer awareness.

—————— Email Extract showcasing Aditya Birla arrogance in Denial of Claim ——————

We would like to draw your attention in our policy wordings Section C. Terms and Conditions, please find below an extract of the same for your kind reference:

Duty of Disclosure
The Policy shall be null and void and no Benefit shall be payable hereunder in the event of an untrue or incorrect statement, misrepresentation, mis-description or non-disclosure of any material particular in the Proposal Form, personal statements, declarations, medical history and connected documents, or any material information having been withheld by the Policyholder or any one acting on their behalf, under this Policy. Under such circumstances We may at Our sole discretion cancel the Policy and the premium paid shall be forfeited to Us.

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The ordeal with Aditya Birla Health Insurance serves as a cautionary tale about the challenges one may face even after diligently securing health coverage. The lack of transparency, broken promises, and a seemingly desperate effort to reject claims, raise concerns about the integrity of the insurance process. As individuals navigating the complexities of health insurance, I advocate for transparency, fairness, and accountability in order to protect our well-being and financial security.

#AskDushyant

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