[Resolved]  National Insurance Company Limited — Delay in - Health Mediclaim Insurance (non Life)

Address:

North Delhi, Delhi

Dear Sir Madam



Request you to update me on my madiclaim reimbursement status.



Regards

Vijay












[protected][protected][protected][protected]

From: Vijay Nagpal [mailto:[protected]@servicesats.com]
Sent: Monday, June 06, 2011 5:05 PM
To: 'IRDA Complaints'
Cc: '[protected]@gmail.com'; 'sanjay ahuja'; '[protected]@nic.co.in'; '[protected]@alankit.com'; '[protected]@nic.co.in'; '[protected]@rediffmail.com'; '[protected]@alankit.com'; '[protected]@nic.co.in'
Subject: RE: Policy No. 360300/48/10/[protected] - Shalini Nagpal (Notional Insurance Co. Ltd.) - Mediclaim
Importance: High



Dear Sir / Madam



Detail as you require mention under below






* Mandatory Fields

*Name of Complainant
Mr. Vijay Nagpal

Communication Details


*Door No./ Bldg/Name/ Floor
B – 362, Nehru Vihar

Street / Area


*City/Town/Panchayath/Village
New Delhi

Taluk/Tehzil


District


*State
Delhi

*Pin Code
110054

E- Mail
[protected]@servicesats.com

Telephone No


*Mobile No
91-[protected]

Fax No


*Insurance Type (Please mentioned Insurance Type
Health Mediclaim Insurance (non Life)

*Life

* Non Life

*Insurance Company Name
National Insurance Company Limited

*Date of Birth of Policy Holder
6th July 1980

*Policy No:
360300/48/10/[protected]

Cover Note:


Other Reference No:


Policy serving Brach Code/Address
National Insurance Co. Ltd. Karam Pura Branch Delhi

*Details of the Complaint (Please type the full details of the complaint)
Please See - As per mail trail

*Have you Approached Insurance Company Regarding This Grievance (If Yes Provide Ref No )
Yes – please see as per mail trail






Request you to revert for more clarification



Thanks & regards

Vijay Nagpal



# [protected]










[protected][protected][protected][protected]

From: IRDA Complaints [mailto:[protected]@irda.gov.in]
Sent: Monday, June 06, 2011 4:50 PM
To: 'Vijay Nagpal'
Subject: RE: Policy No. 360300/48/10/[protected] - Shalini Nagpal (Notional Insurance Co. Ltd.) - Mediclaim



Dear Sir/ Madam,


We acknowledge your mail.


As we found information to be incomplete to register your complaint, we request you to send the complete details in the below mentioned format or you can contact 155255 (Toll Free) to register the complaint.


* Mandatory Fields

*Name of Complainant
Mr./Ms.

Communication Details


*Door No./ Bldg/Name/ Floor


Street / Area


*City/Town/Panchayath/Village


Taluk/Tehzil


District


*State


*Pin Code


E- Mail


Telephone No


*Mobile No
91

Fax No


*Insurance Type (Please mentioned Insurance Type


*Life

* Non Life

*Insurance Company Name


*Date of Birth of Policy Holder


*Policy No:


Cover Note:


Other Reference No:


Policy serving Brach Code/Address


*Details of the Complaint (Please type the full details of the complaint)


*Have you Approached Insurance Company Regarding This Grievance (If Yes Provide Ref No )





Regards,


Consumer Affairs Department


IRDA


Basheerbagh


Hyderabad








[protected][protected][protected][protected]

From: Vijay Nagpal [mailto:[protected]@servicesats.com]
Sent: Monday, June 06, 2011 1:37 PM
To: [protected]@alankit.com; [protected]@nic.co.in
Cc: [protected]@gmail.com; 'sanjay ahuja'; [protected]@irda.gov.in; [protected]@nic.co.in; [protected]@alankit.com; [protected]@nic.co.in; [protected]@rediffmail.com
Subject: RE: Policy No. 360300/48/10/[protected] - Shalini Nagpal (Notional Insurance Co. Ltd.) - Mediclaim
Importance: High



Dear All



Request you to revert on the same else suggest me how can resolve this issue without disturbing you.



Thanks & regards

Vijay Nagpal



# [protected]




[protected][protected][protected][protected]

From: Vijay Nagpal [mailto:[protected]@servicesats.com]
Sent: Friday, June 03, 2011 3:37 PM
To: '[protected]@alankit.com'; '[protected]@nic.co.in'
Cc: '[protected]@gmail.com'; 'sanjay ahuja'; '[protected]@irda.gov.in'; '[protected]@nic.co.in'; '[protected]@alankit.com'; '[protected]@nic.co.in'; '[protected]@rediffmail.com'
Subject: RE: Policy No. 360300/48/10/[protected] - Shalini Nagpal (Notional Insurance Co. Ltd.) - Mediclaim
Importance: High



Dear Mr. GS Sharma / National Insurance



Still not received any revert form your side. Request you to update on the following points and clear my individual health insurance claim as earliest.



This type of delay is only one of the causes to delay in claim reimbursement.



Thanks & regards

Vijay Nagpal



#[protected]












[protected][protected][protected][protected]

From: Vijay Nagpal [mailto:[protected]@servicesats.com]
Sent: Thursday, June 02, 2011 2:03 PM
To: '[protected]@alankit.com'; '[protected]@nic.co.in'
Cc: '[protected]@gmail.com'; 'sanjay ahuja'; '[protected]@irda.gov.in'; '[protected]@nic.co.in'; '[protected]@alankit.com'; '[protected]@nic.co.in'
Subject: RE: Policy No. 360300/48/10/[protected] - Shalini Nagpal (Notional Insurance Co. Ltd.) - Mediclaim
Importance: High



Dear Mr Gauri Sankar Sharma



Yesterday as discuss with you my claim (Policy No. 360300/48/10/[protected] - Shalini Nagpal (Notional Insurance Co. Ltd.) – Mediclaim) / reimbursement file is on hold and refer to National insurance company limited as claim falls under section 11 of the policy.



Request you to clarify on the following points.



What is the meaning of the statement “claim falls under section 11 of the policy”?
When the Insurance Company will not share this type of information / instruction / act with me at the time of policy made, then who is the responsible for this delay.
When I ask to Alankit TPA healthcare on 14th May 2011 (see in e-mail trail) what is procedure of claim submit? Why you can’t response on my mail till date? What is TAT for response / revert the mails in your company (Alankit TPA)
What is next procedure of your company (Alankit TPA) to reimburse the claim when the claim fall under section 11? And what is the TAT for resolve the same?
When can I submit my next claim (post hospitalization) & what are the documents attached with the claim?


My humble requests to you please don’t play with my claim file as office office & don’t put extra ordinary obligation on the genuine claim file.



To, Dear Sir

(National Insurance Co.)



Regarding to the subject matter, when I request to TPA on e-mail so many times and they haven’t reverted on e-mail then I am not the only one responsible for this cause. On 31st May 2011 they’ll say that you have file your claim after the 30 days limit and your claim should be fall under section 11 and confirm the status from NIC, while I have filed all the claim papers / bills file with all original supporting papers as require to Alankit TPA at Zhandewalan office on 18th May 2011 instead of 16th may 2011 according to your one month policy section 11.



How can you insure that all the information / instructions have been shared with the Insurer at the time of health insurance done from your company? And what is next process when you received the claim file from TPA (claim fall under section 11) and what is the requirement from my side to avoid the delay.



My next claim after hospitalization expense is also due and ready to file to Alankit TPA for reimbursement, kindly advice on the same….



Request you to resolve the problem ASAP



Kindly revert for any clarification and process my claim as earliest.



Thanks & regards

Vijay Nagpal



# [protected]



B-362, Nehru Vihar

Delhi – 110054



Policy No. 360300/48/10/[protected]








[protected][protected][protected][protected]

From: Vijay Nagpal [mailto:[protected]@servicesats.com]
Sent: Tuesday, May 31, 2011 4:32 PM
To: '[protected]@alankit.com'
Cc: '[protected]@gmail.com'; 'sanjay ahuja'
Subject: RE: Policy No. 360300/48/10/[protected] - Shalini Nagpal



Dear Sir



I have filed the Ist claim to Alankit and now show the result as under (Original file refer to NIC (claim falls under section 11 of the policy)



Kindly confirm when I can received my claim and what is exact status of my claim



Thanks & regards

Vijay Nagpal














[protected][protected][protected][protected]

From: Vijay Nagpal [mailto:[protected]@servicesats.com]
Sent: Tuesday, May 17, 2011 6:23 PM
To: '[protected]@alankit.com'
Cc: '[protected]@gmail.com'
Subject: RE: Policy No. 360300/48/10/[protected] - Shalini Nagpal



Dear Sir



Please advice on same matter and revert ASAP



Regards

Vijay Nagpal






[protected][protected][protected][protected]

From: Vijay Nagpal [mailto:[protected]@servicesats.com]
Sent: Tuesday, May 17, 2011 9:58 AM
To: '[protected]@alankit.com'
Cc: '[protected]@gmail.com'
Subject: RE: Policy No. 360300/48/10/[protected] - Shalini Nagpal
Importance: High



Dear Sir / Madam



Still revert awaited, please do the needful and update on the same



Regards

Vijay Nagpal

# [protected]








[protected][protected][protected][protected]

From: Vijay Nagpal [mailto:[protected]@servicesats.com]
Sent: Saturday, May 14, 2011 6:27 PM
To: '[protected]@alankit.com'
Cc: '[protected]@gmail.com'
Subject: Policy No. 360300/48/10/[protected] - Shalini Nagpal
Importance: High



Dear Sir/ Madam



This is for your information that Mrs. Shalini Nagpal having medical health insurance policy No. 360300/48/10/[protected] had been hospitalized on 15th April 2011 in Sant Parmanand Hospital, 18 Sham Nath Marg Delhi 110054 due to ENT problem (Acute Membranous Tonsilitis) and discharge on 17th April 2011.



I / hospital have already informed to alankit through fax (CCN : NI[protected] for the reimbursement of this mediclaim.



Doctors have recommended in their report “will require tonsillectomy after one month” and it is supposed to be happen on 20th May 2011 (as per schedule) in same hospital.



I have all the consultancy / medicine / hospital bill from the day one to till date.



Kindly suggest can I submit the claim to alankit along with final treatment charges or shall I file the same in two stages. (hospitalization charges & post hospitalization charges)



Also advise should I intimate to Alankit through FAX / mail / telephonically for the same (post hospitalization charges)



Please do the needful and advice accordingly for claim the all medical reimbursement from Alankit



Thanks & regards

Vijay Nagpal



# [protected]



B-362, Nehru Vihar

Delhi – 110054