How Apollo Munich Health Insurance Harassed Us

So, my father underwent a major surgery recently at Sparsh Hospital in Bengaluru, a large tumor-like thing in the head was discovered in a scan. The photos you see above are after 10 days of surgery (24/06/2017), we took him back to the hospital to remove the stitches. (He was discharged on 20/06/2017)

He was admitted to the hospital on 12/06/2017 trusting the Apollo Munich insurance, as we were well aware that a major surgery like this is going to cost multiple lakhs. 

The hospital's insurance department started the claim initiation and sent the necessary documents. From the day 1, the insurance company started to mess around. They sent the below response to the email.

The hospital had already sent the Doctor's report stating his condition, consultation papers, and the documents related to the scans to Apollo Munich. The Doctor's report had also clearly mentioned that there's no past chronic illness.

Yet, till the end, the insurance company kept sending the same above email. They kept asking "send past treatment documents" over and over again to the point where we got really annoyed. When the doctor's report clearly mentioned that there is no past chronic illness, they kept asking "send past documents". Numerous emails were sent to them in despair, begging them to approve the cashless request, and not create any unnecessary delay, but still, they kept asking for something which didn't exist. It didn't take too long for us to understand that they are just coming up with excuses to reject. They also kept sending the below text message. Notice the date of the last message.

Even on the day of discharge, that is 20/06/2017, motherfkers sent the same nonsense. 

Despite several clarifications over the email and phone calls, on 19/06/2017, they sent a message saying that the cashless request has been rejected. At this point, what would anybody do? I called up their "customer care" number which has an incredibly-annoyingly-frustratingly lengthy way to get to a human speaker, and then disconnects after a few seconds. After several attempts, it got connected, and that guy casually said "it has been rejected". I asked "why" in a raised voice, for which he replied, "documents are pending". Again with a raised voice, I said that the hospital has sent all the required documents what more they want. He put the call on hold with annoying music, and that's it. It didn't seem like he's gonna pick it up again. Look at the number of times I tried below.

Since their "customer care" number was not connecting at all, I called up the Bengaluru office.

To the person who picked up, I said that the insurance claim has been rejected and asked him whom should I speak to. He said "one minute", and then put me on hold with a shitty music.

After this, I wrote the insurance scammers a mail stating that I'll write a blog and let everyone know about their harassment during a serious condition, and ask everyone to stay away from them.

On 19/06/2017, a person called Emanuel from the insurance company calls us at night 7:44 PM. Notice the time and date he calls us. He seems to have carefully chosen the time, probably thinking, "it's already late so let's call for a namesake". He calls us and asks "what actually happened?" very 'innocently', for which my uncle explained everything.

Emanuel said that the hospital had sent an "initial assessment report", where they have mentioned weakness from 4 to 5 years. That weakness is a generic/common age-related thing as my father is now 60+ years. Apparently, the insurance company thinks that this weakness must be related to the cerebellar hemangioblastoma in the head, and wants proof of treatment of that. At this point, it is very clear that the insurance company is coming up with excuses not to approve the claim.

Yet again, Emanuel asked us to send a couple more clarifications from the hospital, and "assured" us that if we send them, he is going to approve the claim. What he asked is nothing new, the same thing all along. The next day morning, we sent it nonetheless.

Even then, the insurance company didn't stop playing nasty games. They sent another email stating "additional information needed", and asked us to send a lawyer's affidavit. It's clear now that these motherfkers are just coming up with lame excuses to reject the claim. 

Emanuel was "clever" enough NOT to mention any affidavit when he called at night.  

We had no choice, but to approach another insurance company, and thankfully, they soon approved more than half of the bill amount, and we paid over Rs 1.25 lakh from our own pocket.

Below are the emails my father sent to them in despair after the surgery.

Another email my father sent after coming home

When my father pointed out that the other insurance company approved without any delay, Apollo Munich's "customer care" person said that the "different companies have different policies". So, I guess Apollo Munich's policy is to harass people.

My advice - Stay as far away as possible from these heartless mofos. They beg you like some pathetic beggars to take their insurance but harass you when you're in trouble.