[Resolved]  Raksha Health Insurance TPA — Chandigarh tpa office for not settling claim of Sandeep Kumar Jyani pf 1359119

Dear Sir/Madam, Respected sir/Madam, My name is Sandeep Kumar Jyani pf 1359116 working at b/o Arniwala sol 030110. Sir last year in November my 3 years old son fell sick and hospitalised then my son admitted in delhi child care hospital sriganganagar rajasthan from 21 to 24 November 2020 then dr told us for meckel's diverticulum test then we went to SDMH hospital jaipur where we tested him meckel's diverticulum and the report was positive then asper doctors advised in December my son got major operation and admitted in Dr Dua Hospital at sriganganagar rajasthan from 14 to 21 December 2020. It was very unbearable pain for my son and after operations we also frequently visited all the doctors as his pain was not stopped after operations also then again in February 7 my son has suffered accute pain and infections in intestine so then we admitted him Jubin multispeciality hospital sriganganagar rajasthan where he was admitted from 7 to 14 February 2021 again his medicine is still in process and we also went to Jaipur in March asper doctors advise for the rest of the test. He is still not recovered. Now I have applied mediclaim 3 bills first bill was of November which I sent in February first week and second of December bills sent in March first week to Raksha Tpa whose receipts are with me after calling from many months they registered my claim in mid April now they are again and again harassing me to send the reasons for delayed submission of bills which I have already sent and another objections was to provide them inpatients facilities certificate which I have also sent them as it was very difficult for me to travel in another state due to lockdown in rajasthan but I managed to reach there and got the certificate as they demanded. Now again they raised new query to harass me as to send them to fill form A duly filled which was already completed asper my knowledge. And now the matter is about my third bill of February this time they are asking original discharge summary and doctor final bills this is really a joke I have sent them original discharge summary and doctors final bills with doctor's stamp on it.but still they are asking pre-printed receipt of doctors final bills which have already been submitted.i have photo copies of all discharge summary and doctors final bills. Now lockdown has imposed in Rajasthan due to which I can't enter in rajasthan border again and again. Sir I called them many time then they registered my claim as after receiving documents in February they are registering my claim in April now sir you may assume who is delaying the bills and asking me to reason for delayed submission. Sir my mediclaim bills has been delaying intentionally and if my bills not cleared I have no option to file a complain against Raksha Tpa to All Indian Bank Union and Ombudsman for mentally harassing me. Because I have all records and courier receipt.As I have submitted all the original and relevant documents which they asked for but they are again and again making same deficiency to harrass me. Sir I want to ask why this TPA is if they can't process my claim. Hope for a solution at head office level Soon. Regards, Sandeep Kumar Jyani Pf 1359116 Tpa member id M581359116PNBA