Formal Complaint – Unjust Claim Rejection Causing Mental & Financial Harassment

This is to raise a serious complaint regarding my ongoing health insurance policy with Tata AIG. My policy has been active since 2016 and a Top-Up policy was taken in 2023.

I am currently hospitalised, and during my discharge process, my claim was suddenly rejected, stating that I did not declare an old treatment. This is completely unacceptable and unjustified.

Since 2016, my policy has been renewed every year without any interruption. No one from your team ever informed me about any requirement of additional declaration or disclosure after the top-up policy was added. The renewal process was done every year simply by collecting premium, without explaining any such condition.

Due to this sudden rejection at a crucial time, I am facing extreme mental harassment and financial distress. I have no funds to pay the hospital bill, and this behaviour from Tata AIG has left me helpless.
Formal Complaint – Unjust Claim Rejection Causing Mental & Financial Harassment

If this issue is not resolved immediately, I will be left with no option but to approach the Consumer Court and IRDAI for relief against this unfair treatment and lack of transparency.

I request your urgent intervention to approve my claim immediately and provide a written explanation for this rejection, along with the exact policy clause that supports your decision.

Policy Details:
Base Policy Number – 0238823600-04
Top up Policy Number:- 0239790920
Name of Insured – Sunil Kumar
Registered Mobile No – 9466768580
Email ID – Sagarkumar4182@gmail.com

Kindly treat this as an urgent complaint and respond at the earliest.

Sincerely,
Sunil Kumar
8930090007

Hello @sagarkumar4182

We have carefully reviewed all the details submitted regarding your complaint. Based on our thorough evaluation, we regret to inform you that the only viable option left is to file a case before the nearest District Consumer Disputes Redressal Forum.
You can file the case through the online e-Jagriti portal: e-jagriti Platform: Ministry of Consumer Affairs, Food, and Public Distribution, Government of India

To initiate your complaint, the following documents need to be submitted:

1. Index – A list of all enclosures/documents attached.
2. Memo of Parties – Details of the complainant(s) and respondent(s).
3. Affidavit – A sworn statement verifying the contents of the complaint.
4. List of Events / Chronology – A timeline of key events related to the issue.
5. Supporting Documents – Invoices, receipts, communication proofs, warranty cards, etc.

---

We can assist you by:

• Drafting all the necessary documents (Index, Complaint, Affidavit, List of Events, etc.)
• Uploading and filing the complaint on the Consumer Forum website on your behalf
• Guiding you through the hearing process and next steps

If you would like to proceed, kindly confirm, and we will begin preparing your case files right away.

Thanks