[Resolved]  The New India Assurance Company Ltd. - Mediclaim Policy - Tpa, Medi Assist India Pvt. Ltd — As Per The New India Assurance Company Rule, TPA not followed the clause no. 4.4.13

Address:

Thane, Maharashtra

Name of company/service: New India Assurance Company – TPA , MediAssist India Pvt. Ltd- Mediclaim Policy

Dear Sir/ Madam,
I have one Mediclaim policy with New India Assurance Company, the polcy no. is[protected] and TPA Ref . No. 2302939. My wife was hospitalised due to Ectopic Pragnancy. The Total Claim is Rs.70000/- .We have Submitted the claim as per their rule to MediAssist India Pvt.Ltd, at Andheri Office. After one weak they replied us that your claim was rejected due to clause no. 4.3.

But as per New India Assurance Company`s Clause No. 4.4.13 says that “Treatment arising from or traceable to pregnancy, childbirth,miscarriage, abortion or complications of any of these including caesarean section , except abdominal operation for extra uterine pragnancy (Ectopic Pragnancy) which is proved by submission o[censored]ltra Sonographic Report and Certification by Gynecologist that it is life threatening ”

If there is clause no 4.4.13 is available regarding to this disease, then How TPA rejected the above claim ? Please lodge my complaint and give me good judgement. My mobile no is [protected]