HDFC ERGO General Insurance Company Limited - HDFC

Recommendation: Not Upheld | Medium: General Public

The ASCI had approached the advertiser for its response in addressing the grievances of the complainant and forwarded the details of the complaint, verbatim, to the advertiser with a request to respond to the same. The advertiser was offered an option to seek an Informal Resolution (IR) of the complaint by modifying or withdrawing the claims in the advertisement, or alternately to substantiate the claims with supporting data. The advertiser was also offered an opportunity for a telecon with the ASCI Secretariat, which they did not avail and submitted their response. The advertiser in their response, stated that the emailer was intended to inform existing customers (policyholders) about the benefits of choosing hospitals from the company’s Preferred Provider Network (PPN). It was not meant to promote policy purchase, contained no time bound conditions, and was sent only to selected existing customers in specific cities. The Consumer Complaints Council (CCC) viewed the Emailer advertisement considered the complaint and the advertiser’s response. The CCC noted that the advertiser has clarified that the emailer was sent to the existing customers of the company. It was meant to inform the policy holders about benefits available through the company’s Preferred Provider Network (PPN). Since the recipients were already insured and not prospective buyers, there was no need to include disclaimers, policy dates, or time bound conditions. The advertiser emphasized that the communication was exclusively sent to existing policyholders in selected cities where the PPN was already established. The advertiser further explained that the services offered through the PPN such as complimentary follow up consultations, discounted health check ups, ambulance assistance, waiver of initial deposit during admission, among others are directly accessible by policyholders at the listed hospitals. Since these benefits are availed directly by the insured persons at the hospital, the company is not involved in each transaction and thus does not maintain records of each instance of service usage. The CCC discussed that the Emailer provided information about available options under the PPN. The claim, “Cut Costs, Not Care…” is a generic statement, not comparative in nature, and not suggesting superiority over other insurers. The CCC also noted that the objections raised by the complainant does not have a meaningful connection to the specific claim made in the emailer and was found to be unrelated to its actual content. The CCC was of the view that the complainant may be an individual with personal grievances, possibly arising from being denied a service or benefit by HDFC ERGO. However, the policyholders continue to have the right to approach the appropriate regulator in case of any grievance. Based on these observations, the CCC concluded that the claim, “Cut Costs, Not Care: With Preferred Hospital Network, non-medical costs are waived for a seamless experience*”, is not objectionable and is not misleading. The said claim is not in contravention of Chapter I of the ASCI Code. This complaint was NOT UPHELD.