[Resolved]  United India Insurance Co Ltd — Reimbursement of Hospitalisation bills covered under Mediclaim.

Address:

South 24 Parganas, West Bengal

Sir, I am a retired employee of SAIL / Bokaro Steel Plant. Our former employer bears the major part of annual Mediclaim renewal cost (effective from January to December) for both the retd. employee and his/her spouse. And the ex-employee bears a part of the fees. SAIL's present tie up is with M/S United India Insurance Co, Ltd (UII) and the ex-employees' claim is settled through the Third Party Administrator (TPA) appointed by the Insurance Co. Since I am settled in Kolkata my case falls under the administrative area of the TPA, viz, M/S MDIndia Healthcare Services (TPA) Pvt.Ltd, 169-Sarat Bose Road, 2nd Floor, Kolkata-700 026 (W.B.).

Unfortunately my wife Mrs. Saswati Deb Sikdar (MIN NO:[protected] had to be hospitalised in Kolkata in a critical condition on 4-4-2011 and diagnosed “Urosepsis with septic shock and multi organ failure. ....She developed episode of hypoxia and bradycardia . She was immediately admitted in the ICU and managed with the mechanical ventrilator, Vesopressors and haemodylasis". Finally she was released on [protected] and in absence of my Mediclaim renewal till then I had to arrange cash payment of the hospitalisation bill of a substantial amount .

On obtaining my Mediclaim renewal confirmation from SAIL / BSL, vide their letter no: BSL/Pers/ Final Settlement Cell/MC/2011, Dated: 19-4-11, I submitted the original hospital bills to the TPA at Kolkata in a file (with 113 page enclosures) on [protected], also enclosing copy of my renewal confirmation letter received from SAIL / BSL for re-imbursement of the bill amount. But on enquiry I could gather from the TPA office that they were still not convinced about renewal of my Mediclaim and my bill has been kept pending. I was taken aback at the level of concern of the TPA authorised by the Insurance Co that they don't feel urgency of bill payment nor do they see reasons for it to communicate, while I am carrying over the interest burden. They neither reply any e-mail query nor the TPA Customer care at their Head Office at Pune (address: S. No. 46/1, E-Space, A2-Wing, 3rd Floor, Pune-Nagar Road, Vadgaonsheri, PUNE-411 014) is accessable through email id given as "[protected]@mdindia.com".

I may have to leave the station for quite a few months, now likely by the 3rd week of June'11. Considering the level of sensitivity of local TPA I don't find any hope of getting my bill re-imbursed shortly, before I leave. It appears that the TPA is going by the principle "Avoid Payment, i[censored]navoidable delay the payment" . But as a retired person I am totally in a soop.

Thanks and regards.
Hemanta Kishore Deb Sikdar
(MIN NO:[protected]
Flat-4 I, Wing-1, Orbit City
82A, Raja S.C. Mullick Road
Kolkata-700 047
Mobile- [protected]