United India Insurance Company [UIIC] — raksha tpa not responding the complaint - some amount deducted contrary to the policy document.-lack of services-claim number [protected] | |||||
As per draft mentioned below i have been following up with raksha tpa and grievance redressal at united india insurance complain redressal mechanism but getting no response, i approached yourself to intervene into the matter and get the claim settled as per policy document. The below complaint was raised on 12 july 2017 vide complaint number Pg[protected] "a claim under the policy as per detail was registered on 18.05.2017 for rs. 7503.00. And in spite of repeated complaint as per token number mentioned below raksha tpa is not responding the complaint and deducted some amount contrary to the policy document. Claim no : [protected] Member id : uic[protected]obcrd Patient name : vinod kumar jain Insured name : vinod kumar jain Date of discharge : 10-may-2017 Hospital name : sakra world hospital Token number[protected] raised on dated 12/06/2017 and token number [protected] raised on dated 20/06/2017 On 22 may, i mailed to enquire the details and reason of less amount of approval of rs. 446/- instead of rs. 7503/- And 06-jun-2017 they informed via claim settlement voucher that deduction/remark bph not covered under domiciliary list, on the basis of policy terms and conditions, claim has been settled as per the instructions o[censored]nited india insurance company. I mentioned time and again that this a claim regarding treatment of prostate and diabetes and its complications.in past also the claim under the same policy for the same decease and same hospital and same medicine was paid by you but now raksha tpa is not responding it. Request you to please reconsider the genuine claim as per policy document and pay the full amount rs. 7503/- (Deduct rs 446/- already paid). In case any clarification from hospital/ doctor is required, please write to me or enquire at your end." In case not responded satisfactorily at your end i have no alternate other than to approach the irda or insurance ombudsman. Hope the matter will be taken at your level and not force me to go to higher level. Thanking you Vinod kumar jain [protected] Was this information helpful? | |||||
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