E-Meditek — Group insurance

Address:	Gurgaon, Haryana, 122002
Website:	www.emeditek.co.in

Hi,

I Work in an MNC and took a group insurance policy of National Insurance Corporation through E-Meditek which is mandatory from office end via Policy No. 344900/46/15/[protected]. During orientation we were told that it’s a corporate policy and with sum assured of Rs.75000/- you will get a benefit of Rs.25, 000/- for maternity and with a sum assured of Rs.2, 00, 000/- you will get the benefit of Rs.50, 000/- and with sum assured Rs.3, 00, 000/- you will get the benefit of Rs.75, 000/-. They also confirmed me that any kind of charged incurred by hospital during hospitalization within the limit will be re-imbursed. Also few days before going to hospital I confirmed the same amount from customer care of E-meditek regarding the claim amount and they confirmed me for Rs.75, 000/- as per corporate policy. I also asked about re-imbursement of bill they confirmed to just submit the bills in our office at Gurgaon and will be cleared within 15 days. Due to an emergency I took my wife to hospital namely Bhagwati Hospital in Rohini Sec-13, New Delhi for treatment on[protected] and my wife got discharged on[protected]. Now I am claiming maternity w.r.t claim No.[protected] for amount Rs.69, 496/- to them. Just few days back I received a mail regarding the Claim settlement that amount of Rs.24, 738/- is approved. They said that as per your policy you are entitled for Rs.50, 000/- under maternity. Now they are stating that the hospital you went is in our panel and we have a settlement with them that for delivery through operation they will charge Rs.24738/- only in case of cashless and if you would have gone to any other hospital which would not have been in panel of E-Meditek they would have cleared our complete amount, however you went to the Hospital which is in our panel so only Rs.24, 738 will be approved. Now they are creating nuisance stating only a fixed amount will be cleared as per their policy. It’s a total fraud from their end for not returning the claimed amount. As of now I feel that I just wasted my money by going for that policy. Please help in resolving the issue.

Regards
Subodh Sharma
[protected]