Raksha Health Insurance TPA — Claim amount not passed stating bills and receipts not attached, where each and every document is submitted in hard copy

Address:

Sushil Bhawan Vijay Nagar Airport Road Totu Shimla Himachal Pradesh 171011

This is to bring in to your kind notice that I had a delivery with C Section whose all the bills and documents were attached and submitted to Raksha TPA in hard copy for Claim Reimbursement amounting Rs 95771/- but the amount approved for reimbursement is Rs 45155/- stating that Pre and Post Amount is not payable and the receipt and various bills have not been attached. I submitted all the Original bills and receipts since my treatment started from Ahmedabad but due to my transfer in between I shifted to Shimla and my delivery took place here. Since, my treatment was taken up from 3 different hospitals, I submitted each and every document in order to claim the reimbursement of the same. And now the amount has been deducted saying that Pre and Post amount is not payable and rest bills are not attached.
You are requested to look into the matter and do the needful at the earliest in order to avoid the Ombudsman complaint.
Looking forward for your kind revert.

Regards
Smriti Chauhan
PNB PF No. - 328541
Raksha TPA Member ID[protected]PNBA
Claim Number - [protected]