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46%
2.76 

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Pune India
ACKO Health Insurance - No Cashless - Misleading
Oct 27, 2024 03:05 PM 954 Views

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ACKO Health INSURANCE – MISLEADING and FRAUD…. NEVER PAYS CLAIM


I had Acko Car insurance for 2 years without any claim so obviously no complaints. Acko offered me 20% discount on initial premium of their Health Insurance PLATINUM PLAN. They promised ZERO waiting period, full family floater plan of 1 Crore. Then they did thorough medical checkup for both me and my wife through lab. After that verified the reports for a week and then offered plan with increased premium.


When after 6-7 months a cashless claim was needed for GI endoscopy where there was evidence of ailment with prescription and existing treatment this ACKO company had following TRICK which they played with multiple other subscribers.


1) They do not pay attention to docs sent by Hospital for cashless claim as required by regulation.


2) They keep asking same documents already sent to them - just to pass the time till procedure date.


3) Then they also suggest to do reimbursement claim – which ACKO never intend to Pay.


4) In my case Acko also told hospital coordinator they are sending approval after some formalities and then delayed another 6 hours intentionally. So hospital told me to get procedure done assuming ACKO will send money after procedure.


5) ACKO in the policy document has clear wording on coverage of all DAY care procedures. Hospital admission, discharge summary, treatment plan and procedure report all provided by hospital. Before this all previous prescriptions and hospital history provided.


After procedure – ACKO thought this procedure was just investigative. They IGNORED the treatment plan, ignored the hospital report BECAUSE THEY JUST WANTED to DENY THE CLAIM…. I had to pay the hospital after 2-3 days for this valid and due claim. DMH Hospital is in TOP 5 hospitals is METRO city like Pune.


Also for a covered member when angiography was suggested ACKO again denied CASHLESS claim by saying you did not tell us about this earlier. As I mentioned in this post ACKO had conducted all tests including ECG, TMT, Ultrasound, Blood, Urine etc to check all parameters before issuing policy. We also answered all their questions.


ACKO finds out innovative NONSENSE reasons and NEVER gives cashless claim. This is JUST 2 – 2.5 year old Health Insurance company which just lure customer by 20% discount to bring cost 10% down than other providers. In my case I took their insurance of annual 36K instead of other 20-30 year established providers offering for 40-42 k annually.


Their Grievance department of 2 level up is NON existing and same level people will copy paste same wrong reasoning and ignoring your docs and comments. I WOULD be filing LEGAL CASE against them for their CHEATING.


I REQUEST ALL to KNOW this FRAUD ACKO HEALTH INSURANCE and DO NOT be VICTIM of their TRICKS. You will save lot of mental pain due to harassment by this ACKO HEALTH INSURANCE CHEATERS…


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