My father was admitted to Amri Hospitals, Bhubaneswar on 16.02.2019 following a sudden brain stroke. As part of the cashless claim, I had already informed Max Bupa about his admission. Max Bupa raised queries regarding his HTN which were responded by the hospital on 25.02.2019. However Max Bupa had rejected the claim themselves and hadn’t communicated about the same either to me or to the hospital. When we contacted them regarding the response, they mentioned they had rejected the claim but didn’t had any answer as to why it wasn’t communicated.
Moreover after I highlighted the entire incident on social media, Max Bupa immediately jumped into the matter with their grievance manager Mohit Gairola stating that Max Bupa has rejected the claim as patient had 4-5 years of HTN which wasn’t disclosed. However the certificate from the treating doctor of Amri hospital confirms that there is no established HTN history nor there is any medical document to prove the same.
Attached are the proofs furnished to confirm that the hospital had provided response to queries from 25.02.2019 itself with repeated reminders addressed to Max Bupa. Max Bupa’s response after the incident was highlighted on social media, fraudulent response to the claim rejection which isn’t mentioned in hospital response and forcing me to sign an exclusion in the policy and threatening to dismiss the policy and forfeit the premium if I don’t abide to their rules.
