Medical Insurance Claim from Raksha TPA — Details of deductions not given
Before I make an official complaint I need to know my rights with regard to a mediclaim made by me.
Details of this claim are available on the following website:
Click on Claim status and on the form that appears fill in
ID Card Number : BN1195327
The claim No is : 12656220708
This claim is made with regard to my son who was recently admitted to Lilavati hospital. The claim amount as per the bills is
However the insurance company has decided to pay me just Rs:2,20,000 and on the website they have mentioned that this
Amount payable restricted to SI + CB : RS 220000/-
I do not follow what this means and want to ask them to give me details as to why they made these deductions.
Before I take this matter up, legally if necessary, I need to know from you if I am entitled to be given such information by Raksha TPA as to how they have arrived at this low figure in the amount reimbursed.
The company giving me the insurance is:
New India Assurance, Fort, Mumbai
They have mailed me the cheque but with a letter stating that if I encash the cheque then this will be considered as the full and final settlement with no additional liabilities on their part.
Therefore I am NOT encashing the cheque until I find out what are my rights in this matter.
Could you please let me know.
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