[Resolved]  Raksha Tpa — Decline claim amount

Address:

Thane, Maharashtra

Greetings Team,

My father was admitted in hospital and got operated for "surgery of genito urinary system". First Raksha tpa approved the amount and later they had cancelled it.When I contacted them they told me submit all the documents, once patient will get discharge and we will look into this. I submitted all the documents on 28 dec 2011 and now they had rejected my claim stating that ' claim denied on ground of exclusion clause'. When I spoke to dr in thunga (Mumbai) hospital they advise me since the operation was an emergency , they need to provide approval.

Kindly let me know what would be my next step ?

Many thanks

Amit Tiwari
[protected]@yahoo.co.in