[Resolved]  Ttk Healthcare Services — Discrepancy and Delay In My Claim Processing

This is with reference to my claim submitted for reimbursement of expenses incurred towards my wife's treatment during and after her hospitalization, under employee group medical insurance scheme of which TTK Healthcare Services is the TPA (Third Party Administrator).

I submitted two claims, of total Rs 55644, with all the bills and other necessary documents, first on 17th March 2008 of Rs 45826 and second on 1^st April 2008 of Rs 9818. I also submitted some more documents on 1^st April 2008 as requested by gayathri.[protected]@ttkhealthcareservices.com in her email to me. I also got an acknowledgement by email, for submission of claims, from [protected]@ttkhealthcareservices.com on 9th April 2008 issuing my Claim No.

Since then I visited their office in Bangalore, many times, for update on the claim processing but did not get any satisfactory answer. The customer care executives there failed to give me the correct status of the claim being processed in any of my visits. Sadly, I have not got any communication from TTK Healthcare Services in this regard so far as well. After more than a month has passed, I am still waiting my claims to be processed and the requested amount to be reimbursed to me.

During my visit to their office on 26^th April 2008, I found a discrepancy in the claim processing by the staff. As mentioned above I submitted claim for total Rs 55644. But, in the details of the disallowed bills, I received from the customer care executive, the total requested amount is mentioned Rs 50, 125. Clearly there is a difference of Rs 5519 in what I actually requested in my claims and what is in their records of my claims under processing. Obviously, there is a clear fault in processing of my claims by their staff.

I visited their office many times, called their customer care representative many times (most of the times there is no response), given applications by email, fax, in written; but all in vain. I have not got any response so far. Nothing has been done till date.

Hence desperately writing this complaint.