Heritage Health Tpa Pvt Ltd Complaints & Reviews

I submit my claim 20 sep 2022 fulfill all query in Nov 2022 but now they are only delaying to settle payment when we call so said every time file pending in internal investigation worst company...

My son got admitted in Manipal hospital Hebbal Bangalore on 21 jul 2022 for 04 days for covid + treatment...total hospital bill was Rs.70, 929/-...amount sanctioned Rs.45, 037/-...amount deducted from.me was Rs.25, 892/-...which was almost 37% of hospital bill...which is very heavy deduction...emp I'd 429667....

Grievance Ref No : HHS.0.W.963156
Indian Bank employee
Claim No : HH[protected] /[protected]
we claim on October 2021 is still pending and asking original payment receipt which are already sent to Nicco House Calcutta by courier on 09th Feb 2022. Nicco House (Corporate Office received original receipt and acknowlegement also received) but this office again and again asking original receipt, I call this office so...

Sr no 59250- Indian bank I have lodged 2claims 2 months back even after submitting all queries also not settling claim no response from anyone and surprisingly they have closed the claim with no reason if asking them simply saying it’s just a procedure not at all fair

Corporation Bank Emp Id 210486
Pol no. [protected]P[protected]
TPAID HHS8. [protected]

Amt Rs. 3029.00
Sanctioned on 26.12.2019
Not Credited to account till date
Geeta Tripathi W/O Nagesh Datta Tripathi...

I Sri Anup Bhunia Indian bank claim no HH[protected] submitted all quiery documents (hard copy). Stll they are asking for same documents which is submitted.They acknowledged the receipt of that copies.still they are not sanctioing my medical reimbursement.

I have submitted all hard copy of quiery.But they are not sanctioing my reimbursement.It seems they do not want to pay.They are asking for the same copy which is àlredy given.

Dear Concern,
This is to request you to pls settle the claim in the name of Mr Subhash Chander Mahajan. He was hospitalised in Jalandhar Sarvodya Hospital. He was admitted from 20/04/21 to 01/05/21 and discharged as expired. I submitted the claim and received query letter in end of may 2021 and I gave reply over mail on 1st June 2021 and second reminder on 06/06/21. It's been one and half month now don't receive any update the status...

Dear Concern

Greetings of the day

i am Rajnish Gupta. my mother usha Gupta was a admitted in Balaji Medicare hospital due covid -19 positive, from 01.05.2021 to 06.05.2021. i paid to hospital full and final bill of Rs. 52095/-. i submit the reimbursement case speed post no EP61485998IN dated 20.05.2021. You received on 04.06.2021.

Your letter sent dated 18.06.2021. I have received the letter...

I Sri Anup Bhunia claim HH[protected] submitted all documents in original.All quiery regarding hospital is not answerable by me.Iwas also suffering from covid. Iam retired.i
lhave given all documents given by hospital....

I contacted providence hospital alleppey kerala for cash less claim for surgery vide ref policy no[protected] name of madhu k v nair family insurance they are not willing to cash less for heritage helath insurance tpa pvt ltd as a huge amount is pending from 2018 onwards for reimbursement to hospital from your company they totally denied to do cash less what can i do its urgent for my wife surgery

Claim no - HH[protected] has been approved for Rs 28881/-agains claim amount Rs 34685 much earlier after giving satisfy reply of each and every query which were raised against submitted documents pertaining to hospitalisation claim of my wife for second Caserean but claim amount yet to be received at my end....

Dear Sir,

With reference to below email we would like to mention following points

No prior intimation resettlement letter regarding settlement amount was send prior to claim settlement No deficiency letter letter mentioning discharge certificate not available was sent prior to settlement of claim .claim was submitted in sep 20 but still March 21 no response no settlement suddenly in week claim was settled due to complaint in ombudsman.also my amount was less processed compared to amt claim .Bill's nearly 99000 not processed by you.so I request you to processed my Bill's n as you have processed for Rs 4 00000 and at that time all documents were there.now you are telling documents went missing while processing file for buffer claim.i don't agree with you n request you to processed my pending bills of Rs 99000 as well as all dhanwantari medical bills mentioned below.your executive sairaj and soummallya das has confirmed all documents were provided to them at claim.please recheck n pay my sum left 120583 immediately.

The settlement had been done as per policy terms and conditions . Please note that the details of items which disallowed from the settlement of the claim as under:-

Rs. 1500.00 on Bill No 942 dated 13/06/2020 (ICU) - DISCHARGE CERTIFICATE / TRANSFER CERTIFICATE FROM DHANWANTRI MEDICAL FOUNDATION NOT ENCLOSED

Rs. 800.00 on Bill No 942 dated 13/06/2020 (Consultant) - DISCHARGE CERTIFICATE / TRANSFER CERTIFICATE FROM DHANWANTRI MEDICAL FOUNDATION NOT ENCLOSED

Rs. 1300.00 on Bill No 942 dated 13/06/2020 (Consumables) - DISCHARGE CERTIFICATE / TRANSFER CERTIFICATE FROM DHANWANTRI MEDICAL FOUNDATION NOT ENCLOSED

Rs. 1082.00 on Bill No 6405 dated 29/06/2020 (Consumables) - FOOD AND BEVERAGE CHARGE NOT PAYABLE.

Rs. 1000.00 on Bill No 6405, . dated 29/06/2020 (Laboratory) - NO DETAILS ENCLOSED FOR LABORATORY CHARGE MENTIONED IN FINAL BILL OF ADITYA BIRLA MEMORIAL HOSPITAL

Rs. 1800.00 on Bill No 942 dated 13/06/2020 (Laboratory) - DISCHARGE CERTIFICATE / TRANSFER CERTIFICATE FROM DHANWANTRI MEDICAL FOUNDATION NOT ENCLOSED

Rs. 500.00 on Bill No 942 dated 13/06/2020 (O2/Gases) - DISCHARGE CERTIFICATE / TRANSFER CERTIFICATE FROM DHANWANTRI MEDICAL FOUNDATION NOT ENCLOSED

Rs. 1500.00 on Bill No 942 dated 13/06/2020 (Ventilator) - DISCHARGE CERTIFICATE / TRANSFER CERTIFICATE FROM DHANWANTRI MEDICAL FOUNDATION NOT ENCLOSED

Rs. 500.00 on Bill No 942S dated 13/06/2020 (Monitoring Charges) - DISCHARGE CERTIFICATE / TRANSFER CERTIFICATE FROM DHANWANTRI MEDICAL FOUNDATION NOT ENCLOSED

Rs. 1082.00 on Bill No 6405 dated 29/06/2020 (F&B) - FOOD AND BEVERAGE CHARGE NOT PAYABLE.

Rs. 200.00 on Bill No 942 dated 13/06/2020 (Registration) - DISCHARGE CERTIFICATE / TRANSFER CERTIFICATE FROM DHANWANTRI MEDICAL FOUNDATION NOT ENCLOSED

Rs. 200.00 on Bill No 942 dated 13/06/2020 (Miscellaneous) - DISCHARGE CERTIFICATE / TRANSFER CERTIFICATE FROM DHANWANTRI MEDICAL FOUNDATION NOT ENCLOSED

Rs. 830.00 on Bill No 942S dated 13/06/2020 (Miscellaneous) - DISCHARGE CERTIFICATE / TRANSFER CERTIFICATE FROM DHANWANTRI MEDICAL FOUNDATION NOT ENCLOSED

Rs. 1445.00 on Bill No 6405 .. dated 29/06/2020 (Ward Consumables / Disposables) - NON PAYABLE EXPENSES.

Rs. 10000.00 on Bill No 6405 dated 29/06/2020 (Room Rent) - ROOM RENT MAXIMUM PAYABLE RS 5000/-PER DAY EXCESS ROOM RENT DEDUCTED CLAUSE 1.2.1(A)

Rs. 395.99 on Bill No 5267 dated 13/06/2020 (Medicines by Shop) - AS PER CLAUSE NO:4.10 NON MEDICAL EXPENSE IS NOT PAYABLE.

Rs. 25072.52 on Bill No 6405, .e dated 29/06/2020 (Consumables) - AS PER CLAUSE NO:4.10 NON MEDICAL EXPENSE IS NOT PAYABLE.

Rs. 5000.00 on Bill No 6405f dated 29/06/2020 (Laboratory) - GLUCOMETER REPORT NOT PAYABLE.GLUCOMETER REPORT NOT ENCLOSED

Rs. 100.00 on Bill No 6405 dated 29/06/2020 (O2/Gases) - BMW CHARGES NOT PAYABLE.

Rs. 1500.00 on Bill No 073 dated 13/06/2020 (Ambulance) - AS PER CLAUSE NO:3.7 AMBULANCE CHARGES ARE PAYABLE UPTO LIMIT RS 2500/- PER TRIP

Hope, above details would clear you the basis of our settlement in the instant case

Regards,

Sayan Roy
Heritage Health Insurance TPA Pvt. Ltd.
IRDAI License no : 008 ; CIN -U85195WB1998PTC088562
Regd Office - McLEOD HOUSE, 3 N. S Road,
Kolkata - 700001, India
Corporate office - NICCO HOUSE, 5th Floor, 2 Hare Street, Kolkata - 700001, India
Telephone No[protected]; Fax No[protected];
Website - heritagehealthtpa.com

From: chirag nanda [mailto:[protected]@gmail.com]
Sent: Sunday, May 30, 2021 11:14 PM
To: [protected]@irdai.gov.in
Cc: Sayan Roy; Corporation Bank Heritage; Heritage Complaint; [protected]@gmail.com
Subject: I am sharing 'complaints-data-format (1)' with youPlease refer my claim carefully. My buffer amount approved is 343436 but you have processed only222583 and settled only 166766 . Why my amount rs 120853 not processed. Why only 222583 processed if limit f

Dear Sir please find complaint data of my claim for heritage IRDA chirag nanda [protected]

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[protected] Forwarded message[protected]
From: chirag nanda
Date: Sun, 6 Jun 2021, 12:38
Subject: Re: FW: FW: FW: I am sharing 'complaints-data-format (1)' with youPlease refer my claim carefully. My buffer amount approved is 343436 but you have processed only222583 and settled only 166766 . Why my amount rs 120853 not processed. Why only 222583 processed

Claim no HH[protected]
Received dt 16/01/2020
Name Latika Mishra
Designation Manager
PF no 33458
Claim amount Rs.54193/-

We have submitted our claim for policy no[protected].
We have received a text message on a registered mobile number for claim settlement.

*In the deduction letter it's been mentioned that Rs. 8000.00 on Bill No 0001 dated 24/08/2020 (C.T. Scan) - DOUBLE BILL.
Reply we sent: This amount we have paid by card on 24th August 2020, even in medi-assist hospital have not submitted this bill because it was a pre-hospitalization investigation.

We have sent mail to TPA to clarify these points, we haven't received any revert from their side till date.

My SPF NO. 30714
CLAIM HH[protected]
I along with my husband was detected covid -19 positive in last of July 2020 and admitted to hospital. We submitted all the documents provided by the hospital. Still they are not satisfied and repeatedly asking for the documents and their meaningless criteria just for harassment. Actually they are trying to avoid our claim.
If they have any doubt why didn't they contact to the hospital?
Very bad service..actually bad intension.
No cooperation at all...just it is a business.

We have sumitted document before 5 month.. claim was approved in month of October.. still we have not recived money... We are trying calling customer care no.. no one picking the phone..

Claim no HH[protected] for Rs 175817/--

My claim is pending since last more 2 months, 3 queries raises on 09/09/2020 i replied on the same through mail and i forwarded hard copies on 22/09/2020 their regional office bangalore, 2 months over but no reply from them, if i call to bangalre regional officer they sais we jave forwarded to concern department, if i call to toll free no it will take 1 hour to connect concern department, and they are telling they have not recieved the documents, so many mails send but no reply from their side hence again take the prints of that softcopy and again forward same documets 15 days back, but still no use i am fed of with these guys for just simple 3 quiries updatae they r taking months, then when my calim going to settle and when they will credit amount, plz help me wt to do regarding this

Iam ( M RAMANAYYA, Emp. No. 210798)working in Corporation Bank, Kakinada claimed an amount of Rs.15713-00 and approved on[protected] itsel[censored]nder claim id: HH[protected]. I came to know that the above mentioned amount was bounced due to wrong account number. Now, iam sending my bank account details. IFSC: CORP0000162, Account No.[protected]. Corporation Bank, Kakinada, M Ramanayya. Please send the above mentioned amount to my bank account at the earliest. I have mailed the banks details also to mail id:corpbank.[protected]@bajoria.in

I am to state that I am a bank employee with ID 59481. My policy No. is HHS1.[protected]. My name is Sandhya Kalathil. My mother-in-law, T.P.Vijaya is a Ovarian cancer patient. She is taking her treatment at Yashoda Hospital, malakpet, Hyderabad. She recurred cancer due to which she was advised chemo by the doctors at Yashoda hospital. After recurrence, she underwent 2 cycles from my earlier insurance support (United India Insurance Company Limited with Health Insurance as ) cashless treatment. In the two cycles, no amount was deducted and the entire amount was settled to the hospital by the insurance authorities.
While things stood thus, my insurance got renewed with National Insurance Company Limited with Heritage as TPA from 1st October, 2020. As usual, my mother-in-law underwent chemo in the month of October, 2020 but, to my utter surprise, the whole amount of treatment is not settled with hospital and some amount towards " CHEMO ADMINISTRATION AND INFUSION CHARGES RS.2, 250/-, CANULA CHARGES APRETERO 125 MG KIT and other expenses totalling Rs.6, 922/- was not paid by the insurance authorities on the ground that it is "NON MEDICAL EXPENSES".
I kindly request you to clarify me how can the above expenditure be categorized as non medical expenditure when it is used for medical purpose. When the company pays money for chemo medicine, then the medicine has to be infused. So, infusion charges cannot be categorized as Non Medical expense when the expenditure towards medicine is categorized as Medical expenditure. Further, the tablet, APRETERO will be given at the time of chemo to prevent the side effects of chemo. This is also a medical expenditure. This medicine cannot be taken in a casual manner. It is has to be administered only at the time of chemo. Then how can this amount be categorized as a Non Medical expenditure. Further, the amount spent for syringes etc. all are used for medical purpose. All those amounts cannot be categorized as Non Medical Expenditure.
In this regard, I requested the Heritage TPA office through the grievance cell to look into the issue and reimburse me the amount of Rs.6, 922/- spent by me. My complaint was also registered vide reference No.HHS.NIC.W.950243 on 17.11.2020. I many a time tried to see the status of my complaint through the website of Heritage Insurance policy, but there is no option in that website for viewing the status of the grievance except for giving grievance. Further, there is no response from company also. In this regard, I request you to issue necessary instructions to the concerned to go through the entire case record and reimburse me the amount of Rs.6, 922/- paid by me to the hospital authorities.

With regards

Sandya.K

Policy no.[protected]P[protected], policy year 2019-20 o[censored]nited india insurance co. group mediclaim policy IBA a/c Ucobank. TPA card no. HHS8.[protected]. STAFF no.20677, UCOBANK RETIRED STAFF. CLAIM NO.HH.UII.M.01224716. Claim file deposited personaly over counter of Heritage TPA's Ahmedabad office. Heritage TPA not informing status of claim or query details and just remain silent. they are delaying approval or processing intentionally. please...

My mediclaim no. HH[protected] for Rs 90985/- under IBA mediclaim for retirees, is pending since 16.06.20. Queries raised on 24, & 28.07.20 were immediately replied. Last query raised on 21.08.20, regarding sharing of POD was replied on the same day n speed post details alongwith it's receipt screen shot were sent via email. Despite repeated requests on 19.09.20, 28.09.20 & 09.10.20, discussion held with Madam Varnali but no positive response. Kindly take up the matter and do the needful.
Pramod Kumar Jain
Manager Retd
Allahabad Bank
Emp. ID. 9003

My claim for Rs 90985/- is pending since 16.06.20. no response from the Deptt. despite repeated requests on 19.09.20, 28.09.20 & 09.10.20. last query raised on 21.08.20 was replied on the same day.

Policy No.[protected]P[protected]IBA Policy - Claim No.HH[protected]Patient Name - Sunita Narang, (Card No.HHS8.[protected])- EmployeeNo.015132 o[censored]COBank. Main Cardholder -Anmol Rattan Narang
I had submitted all claim papers as per check-list on 04.08.2020 by speed post.
Heritage Health raised 3 queries on 30.08.2020.
All the three queries were replied by me on 15.0p.2020, attaching all required papers. On tracking on India Post, I observed that the envelope reached them on 19.09.20 (Speed Post Receipt No. EP[protected]IN).
Telephoned Heritage on toll free number on 22.09.20 with their representative Aparna who assured to get the claim passed by 29.09.2020.
Again telephoned on tollfree number on 2 9.09.20, who advised towait for one more week.
On 03.10.2020, Heritage repeated queries made on 30.08.20 on 03.10.20.
All queries againrepliedon 03.10.2020 by e mail and by speedpost on 05.10.20 (Speed Post Receipt No.EP[protected]I)
Nobody responding to telephone calls. Please Help.

Hello sir
My self vinayak chauhan emp I'd: 224471 working in Corporation bank Dhrangadhra branch.
I have send query reply of my claim no: HH[protected] on 4th August 2020. Your employees of heritage health office Rajkot received the courier document from our Rajkot zonal office on 4th August. Still there is no update about further progress of my claim.
Kindly check and update me the latest status of my claim.
Almost 45 days are passed but still there is no update about my claim.
Please help me for further process of my claim.
My contact number is [protected].

Hello sir,
My self vinayak chauhan working in corporation bank dhrangadhra branch, surendranagar district.
My employee id is 224471.
I have submitted claim documents of my spouse. My claim number is hh[protected].
After i sometime i have received query regarding requirements o[censored]sg fero profile report and i have send the query documents on 4/8/20 and as per pod number i have checked the document received on 6/8/20. Still 1.5 month is passed but there is no reply comes. I have daily send mails but no reply given in mail. Through phone call they are telling like you can call tomorrow or our server is not responding as so many reasons given.
Please process my claim as soon as possible and update me the latest status of my claim.
My contact number is [protected]

Name:manikandan
Claim number:hh[protected]/[protected]c[protected]
Card number:hhs8.[protected]

My claim has been sent on 2/12/2019, you asked query on that at 27/12/2019. We had replied that query on 02/01/2020. Also you had asked query on 15/02/2020
We sent reply by mail om 17/02/2020. After that bank branch manager considered a mam in your office in phone. And attached the bill that you asked in query by courier. I cant able to sent that you asking because that hospital provides this like bills only. Heritage insurance is giving me pressure and tension for 19, 000. If it is a large amount what can we do.

Please find below my policy details

Policy no -[protected]

My medical insurance is not covered and rejected due to no valid reason.

I have opted for the squint eye surgery and due to which i have acquired the vison issues.

The same has been reported by dr bv rao from shreya eye clinick and same has be been communicated to the heritage team but they have rejected the cash less amount.

I have opted for vidal health insurance through new india insurance but not sure why i got the heritage insurance, however please process my cash less insurance amount or will take an necessary action against you.

The issue is with saritha, assistant manager sathis, and manager ruhi from hyderabad heritage office located at babukhan state, the issue is with their misbehavior on the call when call to discuss about the calim, the have rejected the claim due to unlogical inputs, hence request you to take strickt action against them on the issue.

Id : hh[protected].. Heritage health insurance.. Proposer:uco bank
. I have been delivered a baby girl on 23.02.2019..., i have submitted my all query replies but still they are holding my claim is in investigation department only.. Already 7 month passed.. Again and again they said queries pending pending... This is totally unfair.. When it will be sanctioned. Please reply.

I am diganta narayan choudhury
Age: 30 years
Card no : hhs3.[protected]

The company has not sent me my health card even after i have renewed my health insurance online under oriental insurance. It been 3 months (11.08.2017) since my card has expired.in spite of having my present address records and sending me repreated reminders to renew my policy before the above mentioned date the company has not sent me my new policy when i renewed my policy within the give date. Their contact numbers are always engaged and it is next to impossible to get through to them.

Oriental insurance should reconsider their options and decide whether they wish to continue their allliance with heritage health due to the latter party being so unprofessional and poor service provider.