| Name of Complainant | |
| Date of Complaint | July 23, 2020 |
| Name(s) of companies complained against | ICICI LOMBARD GENERAL INSURANCE COMPANY LIMITED |
| Category of complaint | Insurance |
| Permanent link of complaint | Right click to copy link |
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Name : Jainam P Doshi, Policy Number : 4015i/P-IGCHI/172898244/00/000
I have originally bought ICICI Lombard Health insurance policy in June,2018 having policy number 4015/143765521/00/000 and UHID : IL16062511500. The policy was effective from 12/06/2019 and was expired on 11/06/2019. On expiry of the same I have get the policy renewed having policy no. 4015i/P-IGCHI/172898244/00/000 without change in any T&C or any coverage. At the time of buying the policy, I was informed by the policy seller that My Policy contains OPD Coverage of upto Rs.4000/- per year with condition of one time claim in a year and above OPD coverage includes Exp. on GYM Bills, Lense of Spectacles. However to confirm the same I sought confirmation from company whether exp. on GYM Bills covered under OPD and company had given me the confirmation via email dated 03/06/2019 that GYM bills are covered under my policy subject to maximum of Rs.4000/-, payable on Re-reimbursement basis only once in a policy year. Copy of the screen shot of email confirmation given by ICICI Lombard is enclosed herewith. The confirmation justifies that I was entitled to claim exp. incurred on GYM during the policy period subject to max Rs.4000/-. On expiry of the original policy, I have get it renewed without change in any features of the policy such as Sum insured, different type of IPD and OPD coverage etc. This simply justifies that as i have simply renew my policy without any change, all the coverage available for old policy are available under new policy. Now during the second policy period i.e. 12/06/2019 to 11/06/2020 I have incurred expenses such as Dr. Visiting fees, Medicine purchase, lab. test and Gym Fees. I have filed the OPD claim submitting original bills claiming above mentioned expenses. However company has rejected my claim on basis of argument that GYM bills were covered under my previous policy only and not covered under my renewed policy. This argument is baseless as at the time of renewal of the policy, I have not received any intimation from company regarding any change in my policy. This simply implies that all the coverage of previous policy are available in renewed policy.
