Browsing articles in "Mediclaim Complaints"
Dec 23, 2009
Insurance India
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Mediclaim not settled

Sub: Mediclaim for Mr. Murari Lal Goel, Policy No. HWT-00001789-000-00
Membership No. A16171Y with Cholamandalam MS General Insurance Chennai

Dear Sir,

I have submitted a Medical bill of my father for Rs. 18, 700/-, which was hospitalized during 05th-MARCH-2009 to 08th-MARCH-2009 at BHAGAT HOSPITAL JANAKPURI NEW DELHI-110058. Verizon Galaxy Nexus strong battery

Our Company has taken a Group Mediclame Policy along with all my family members for more than five years with Oriental insurance, ICICI Lombard, Reliance General Insurance & Cholamandalam MS General Insurance Company Ltd, (Photocopy of policies already given at time of renewal of policies)

Cholamandalam MS General Insurance, Chennai have denied my claim, on the basis of pre existing disease & policy discontinuity, but as per the IRDA norms my father has already been covered under mediclaim from General Insurance Companies for more than five years.

In view of the above the reason given on rejection is not satisfactory & request to reconsider my claim.

I write many times to the Insurance Company, they neither settle my claim nor given me the proper reply. Kindly look into the matter on urgently basic & settle my claim on priority basis.

Thanking you,

for INDFOS INDUSRIES LTD.

Raj Kumar Goal
E-343, Street No. 19
Sadh Nagar Palam Colony
Palam New Delhi-110045
Phone No. 25032640, 09871387739 (M)

Dec 23, 2009
Insurance India
1 Comment

Curtailed Claim From RAKSHA TPA COMPLAINT

I had filled a claim for my hospitalisation with RAKSHA TPA, Insured with New India Assurance ltd.
Claim had original hospital bill & on query raised even submitted Hospital in house log sheet which was given by hospital (Bhatia Hospital).
In house panel of TPA construed that hospital stay was prolonged hence deducted the claim by all most 25% directly, this means standard given by mediclaim policy issuer company ( The New India Assurance Company Limited) has mandated to all TPA’s to deduct 25% of all claims received, those coming back on case to case basis, will be approved or further process per merits.
I need assistance in filling this legitimate case for full recovery as well mental trauma.
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