[Resolved]  National Insurance Company Limited — Mediclaim does not give by the company

Date: 26/10/2012


To,
The National Insurance Company Limited
6, Lyons Range, 2nd Floor, Kolkata – 700001

Ref: Claim under Policy no: 101600/48/11/[protected]
Claim no: NI-6-92940

Dear Sir,

With reference to the above, and letter dated 10/10/12, I am surprised to note content.

Firstly. I sincerely regret of the allegation that there is suppression of material facts. In the year 2009, my age was 46 years and the agent did not ask me for any medical test to be conducted prior to the medical policy.

Moreover, in the discharge summary of RTIICS, it states” THIS PATIENT IS NORMOTENSIVE. IN THE INITIAL PTC REPORT SUMMARY HE HAS BEEN MISTAKENLY MENTIONED AS HYPERTENSIVE. THIS HAS BEEN SUBSEQUENTLY CORRECTED”.

On the basis of RTIICS report, my claim for cashless facility was rejected.
But letter when they corrected their mistake, then why National Insurance Company Limited is not accepting the facts. Is it not contradictory on the part of the National Insurance Co. Ltd.
Why is RTIICS, name included in GUIDE BOOK-NETWORK HOSPITAL LIST.
If National Insurance Company Limited does not have faith in the RTIICS, then their name should be removed from Network Hospital list.

Moreover, I am staying on the 3rd Floor of the building without lift for last 25 years, If I was hypertension patient or suffering from any type of disease relating to heart, then I would not have been staying here. This is my first instance that I have been admitted to a hospital/nursing home after birth.

I would like to bring to your notice that when Dr. Dhiman of GENINS INDIA TPA Ltd. Visited for clarification and finding, co incidensely Dr. Debdatta Bhattacharya and Dr. Debabrata Chatterjee was present. He did question the doctors about the cause of Mr. VINOY ARYA’s admission to RTIICE. The doctors clarified Dr. Dhiman that it was an accident which took place and can happen with any human being. Moreover, Dr. Dhiman was quite satisfied and assured me that please file the claim, it will be met.

I would request National Insurance Company limited, to get a second opinion from RTIICS and inform us immediately as the claim is nearly five month old.

In convenience caused is regretted.

Thanking You
(VINOY ARYA)
9/5, TALBAGAN LANE, ORIENT ROW, KOLKATA - 17
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Aug 13, 2020
Complaint marked as Resolved 
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National Insurance Co. Ltd — MEDIClaim not paid TILL DATE

Its very very discouraging & shame full act is being done by this Insurance company, and what is the benefit of dealing with such and un reliable company, who cannot pay claims on time CLAIM NO.NIC-2/31010

NATIONAL INSURANCE CO. LTD
DIVISION OFFICE 8,
C-3, PUJA HOUSE,
KARAM PURA COMM. COMPLEX,
NEW DELHI-110015

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