Oriental Insurance Company — Insurer asking for irrelevant claim documents, Claim Partial Rejected

Address:

Raksha Health Insurance TPA Pvt.Ltd. Plot no. 42 ,Victora Building ,First Floor,Sector 20A Near ICAI Building,Faridabad, Haryana-121013 Phone: 0129-35

Dear Team,
This is to inform you that I am working with Baroda UP Bank and having group health insurance with The Oriental Insurance Co Ltd and the policy number is 221300/48/2023/1130.
I had an accident on 17th March 2023 and my elbow was broken and I had to undergo elbow surgery. After that I have submitted all required medical documents to the company for reimbursement purposes. My claim number is [protected]. After the process and some query my Claim was passed but the company deducted the amount of the implant (Rs 20896) that was used in my surgery with reason patient name not mentioned in the implant bill. I have contacted the customer care for inquire for the same and inform them that the implant was purchased by the hospital so the bill was in the name of hospital and I paid the total surgery cost as a breakup wise bill provided by the hospital. But the customer care representative told me that the patient name should be mentioned on the bill. After that he suggested for submit a written declaration from the hospital in their letter head to confirm that the purchased implant was used in my Surgery.
After that I contacted the hospital and arranged the written confirmation for the same on the hospitals letterhead with a doctors sign and seal and submitted it to the company. But still again the claim was rejected by the company stating that hospital letter is not sufficient to pay the invoice amount and arrange to provide a proper invoice with the patient name mentioned. But the problem is that the invoice was already issued in the name of the hospital and how can I get another invoice. And the hospital already provided written confirmation for the same that was sufficient to prove that the implant was used in my surgery. But the insurance company deliberately rejected the claim with unfair reason.
All the supporting documents are attached here for your reference, kindly look into the matter and do the needful to resolve the issue and help me to receive my claim amount.

Thanks and Regards,
Kumar Shubham
Mob: [protected]