Subject: Rejection Claim Number 220202008443 - JORGE RAFAEL BLANCHART ORTIZ
From: [email-masked]
To: [email-masked]
Date: Tue, 29 Dec 2020 15:12:25 +0530

|

Ref                  :  CPU37

Date :  29-DEC-2020
To

ASHISH DABRAL | |

CHERRY E COMMERCE SERVICES P LTD
A-72, SECTOR-2 GAUTAM BUDDHA NAGAR UTTAR PRADESH-201301
GAUTAM BUDH NAGAR,Uttar Pradesh-201301

Dear Sir/Madam,
| Claim Number | 220202008443 |
| Claim of | JORGE RAFAEL BLANCHART ORTIZ |
| UHID | IL17815441000 |
| Policy Number | 4016/X/195525873/00/000 |
| Policy Name | CHERRY E COMMERCE SERVICES P LTD |
| Coverage Period | 22-FEB-20 to 21-FEB-21 |
| Date of Admission | 26-JUN-20 |

On behalf of ICICI Lombard General Insurance Co. Ltd, we thank you for preferring ICICI Lombard as your health insurance partner.

We have perused the documents submitted by you and regret to inform you that your claim cannot be settled for the following reasons.

Sr No | Reason | Description

1

OTHERS

Reject : We regret to inform you that your claim is rejected due to non receipt of requested documents

We continue to remain committed to you as a valued customer and assure you the best services at all times.

Should you like any further clarification, please feel free to write to us at the below mentioned address, or e-mail us according to your preference, quoting the above claim no, and we shall be pleased to assist.

“In case you have any query, kindly contact us within a period of 8 weeks. In case no response is received from your end within 8 weeks, the claim would be considered as accepted Rejection from our end”

“In case you are not satisfied with the resolution provided, you may visit our website https://www.icicilombard.com/content/ilom-en/ServiceCouncil/SQindex.html for Grievance Redressal procedure and Insurance Ombudsman office details for the resolution of your grievance”

Associate Vice President- Health Claims

For ICICI Lombard General Insurance Company Ltd
ICICI LOMBARD HEALTH CARE

**Disclaimer: ICICI Lombard can pre-authorize cashless treatment subject to the terms and conditions of the policy based on the adequate, relevant medical information. However the patient is advised to continue/follow his/her treatment as advised by the treating doctor and not to discontinue the same pending the processing of preauthorization request

Contact Details: | Email: [email-masked]

Address: | Contact Us |

ICICI Lombard GIC,
ICICI Lombard Health Care,
ICICI Bank Tower,
Plot No 12, Financial District,
Nanakram Guda, Gachibowli,
Hyderabad – 500032, Telangana
IRDA Registration No. 115

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