Vipul Medcorp — my file no. is 20cb01uih1825. denied claim without query

Address:

r delhi-92, New Delhi, Delhi, 110092

Dear sir

It is very unfortunate that my experience with tpa vipul at max hospital has been horrible. My spouse (Mrs. Deepa) was admitted at max hospital vaishali - ghaziabad on 28.11.2019. Cashless day care hysterectomy was already approved on 27.11.2019.

And the procedure was done by dr. Sushma dikhit on 28.11.2019. But at the time of final settlement, tpa denied full claim.
Patient mrs. Deepa was admitted in hospital at around 7 am on 28.11.2019, procedure was done thereafter. At around 5pm, hospital sent the documents like discharge summary and the final settlement to tpa. Tpa denied it fully and i was compelled to pay the hospital bill on my own. At night in max hospital don't have any choice left.
In a situation where i am paying premium every year wef 2012, i felt cheated. This was the first time i have claimed to tpa which was rejected very causally, without any query or any logical explanation. While initially at the time of approval they had clarified each and everything with doctor about their query. I want to know why they were in such a hurry to deny my claim. Is this a right practice by company where a customer is harassed. So consider this matter as my grievance.

Now it’s my humble request to review the matter as earliest as possible. My file no. Is 20cb01uih1825.

If my problem is not resolved even after sending this email, i will be force to take strict action and approach the consumer forum.

Hoping for a positive response.

Thanks & regards