I, Pinnamaneni Rajarao, aged 62 years and resident of Gandhinagaram village in West Godavari of Andhra Pradesh, agriculture by profession, has been lured into taking IndiaFirst Money Back Health Insurance Policy for self in connivance with the Bank staff at Bank of Baroda, Yernagudem Branch. While issuing policy, I have been subjected to the comprehensive Health Check-up by the company’s panel doctor and basing on his findings, I have been issued with a policy bearing No. 10206181 and Client ID:52581908 during 2011-12. It was during December,2012, I suffered excruciating pain in my right leg and have been shifted to Indus Hospitals, Visakhapatnam on 09th January,2013. Before joining as In-patient, I called the help line of the Insurance company but could not get in touch with the right person for obtaining prior approval. I have undergone operation for Lumbar Canal Stenosis on the same day and was discharged on 12th January,2013. While discharging the Neuro surgeon who attended on me has recorded his findings as the disease is persisting since 2 months. Basing on his findings, I called the customer care of the Insurance provider and asked him to reimburse my hospital costs. But they declined to entertain my claim stating that they do not entertain any claim for the pre-existing diseases. It is unfortunate that the Panel doctor who conducted comprehensive check up did not mention anything about the existence of this disease except mentioning about Hypertensive and diabetes for which I have been charged extra premium. Even the Super specialist who conducted surgery also opined that the disease is prevailing since the last two months. Ignoring the opinion of the super specialist from their network hospital, they declined the claim which is nothing but criminal misconduct to avoid the claim.

I want the claim of Rs.2,80,000/- which was actually incurred for undergoing operation, hospital charges, medicines etc., plus the costs inclusive of interest from 12th January, 2013 till to the date of settlement of claim along with damages of Rs. 1 lakh to compensate the mental agony and harassment I faced.

Complainant Information
name- prajarao