(Category Air)

NEW INDIA INSCE ,REJECTIONS, DISALLOWANCE FROM 1/7/14 ON THE RISE,TOUCHING & REALISTIC NARRATION,
TIME TO IMPRESS LIC MGT ON REALITY

From: RAM SHARAN AHUJA <rsahuja>

Subject: Re: Mtg with ED P & Top Management

Dear Shri Kishore,

Thanks for your mail.

I have to make the following observations which need discussion at the next meeting with the Top Management of LIC.

1. There should be NO upper limit on room charges. I suffered last year when my wife was admitted to Saifi Hospital, Mumbai, in an emergency. She was straightaway taken to ICU where she was charged Rs.3500 per day. But after 10 days, the doctor advised her to be shifted to the ward. To my shock, I found that the minimum charges for a single room were Rs.8500 + 20% surcharge. The upper limit as per new policy conditions, was Rs.7500. I could have borne the difference of Rs.1000 but the problem did not end there. As per policy conditions, surcharge was not payable, which meant an additional loss of Rs.1700. This could also have been absorbed but the shock was still in store. I was told that the ICU charges would be increased to Rs.11500 + 20% surcharge RETROSPECTIVELY. I had already suffered a personal loss of around Rs.50,000 for the items disallowed as per NEW POLICY CONDITIONS implemented from 1/7/2014. This would have meant a further loss of around Rs.100,000 which I could ill afford. Eventually, I had shift to Breach Candy Hospital at 11 p.m. because the room charges were Rs.7500 and there was no surcharge.

2. I find that till 30/6/2014, New India Assurance Co. used to absorb all charges legitimately levied by the Hospital. But after 1/7/2014, there was a sudden disallowance of many items, which were provided by Hospital. I had no say or choice in calling those items which were needed for care of my wife, as per Dr’s recommendations. While settling my bill for replacement of my wife’s knee, the company disallowed more than Rs.150,000 on different pretexts.

3. It seems that by increasing the over-all cover, the company has found a way to grab more premium from LIC and reduce the cost of reimbursement by disallowing genuine items as prescribed by the hospitals/doctors.

Kindly consider these points and take them up with the top management so that from 1/4/2016, New India should not succeed in taking LIC for a ride.

Regards

RS Ahuja