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Mediclaim Complaints & Reviews

Cashless denied for My dad, cancer is detected just 20 days back.
With no proper response from agent and company both. Request you to please look after this on Urgent basis.
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    Dear sir / madam,

    I am working in it complany, chennai,
    I have submitted the claim for rs 98, 000/-
    Received claim amount only rs 71, 000, but amount paid by corporate is: rs.89, 000/-
    Still 18, 000/- pending from that claim. Sent many mails to "rn. [protected]@marsh.com" chennai team.
    Now they are telling like pre-hospitalization bill date and reports date is mismatching, just one week difference is there, how could it possible all the tests on same day? Taken around 1 week for complete all the tests. You people may know about cancer treatment, many investigations done before treatment. Impossible to complete all the tests on same date.

    Excess of eligible category of room rent & nursing charges deducted under charge type 'investigation & lab charges'.
    Again deducted excess of ot charges for the eligible category of room rent & nursing charges from surgery charges.
    I received only rs.71, 000/-, please kindly check and process my claim for pending amount.

    Kindly do the needful at the earliest.
    Thank you
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      This is to inform you that i have submitted one mediclaim case is no 14120754 it's been continuous flowup since two months with mediassit but inpaction report has been pending from company end and no one is helping about the said case. I am fail to understand what kind of services are you giving in such etmeed organization this the worst service i ever had.
      Kindly process the settlement or i will write to nodal officer of mediassit india and escalate the matter like anything.
      May 02, 2017
      Updated by Sunny Manak
      No revert received
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        Sir, me rajesh goyal ne indian overseas bank ke marfat emeditek company ki mediclaim policy le rakhi h aur me 7 july 2015 ko mahaveer cancer hopital me admit hua tha tab se mera claim aapke yaha book he but abhi tak query ke alawa mujhe kuch nahi mila he aur mujhe bharose me rakh rakha he .mene logo se paisa udhar leke hospital me paisa jama karaya he but abhi tak koi payment ka rasta aapki taraf se najar nahi aa raha he . ab ya to mujhe consumer court me jana chiye ya media me ye aap hi bataye kyuki meri marne jaisi halat ho rahi he jisme logo ka karja itna badta ja raha he jiska mere pass koi ilaj nahi he . mera cliam no.[protected] he aur name rajesh goyal he . ab aap ya to mujhe mera claim pass karo ya mujhe majbooran media ko aapki isththi batani padegi aur consumer court ka darwaja khatkhatana padega.. rajesh goyal [protected] [protected]
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          Respected Sir, My mom rashmi garg is hospitalized on Monday (Mohan hospital, bulandshahr) . As she has a cashless card (policy no[protected],[protected], I presented it to the hospital. they generated a bill and sent a bill to TPA (paramount health care), but till now they haven't paid my mothers bill . The hospital is constantly harassing us for the payments . please see in this matter or I will take help of consumer forum, legal help . I have constantly paid premium for the policies from 2010. I think Max life played a false game with us. Thanking u yours truly Aishwarya Garg s/o Rashmi garg policies[protected],[protected] Max life insurance
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            P/171100/01/2014/012323Policy No STAR HEALTH AND ALLIED INSURANCE CO LTD, Annual preium paid Rs 21050 Medi Classic IndividualType of Policy policy taken under sr. citizen category, where claim will be 70% company's and 30% ours share. While disbursement they gave didnt give as per the commitment. we spent a lot on his operation, and request you to kindly get what is the rightful...
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              P/171100/01/2014/012323Policy No STAR HEALTH AND ALLIED INSURANCE CO LTD, Annual preium paid Rs 21050 Medi Classic IndividualType of Policy policy taken under sr. citizen category, where claim will be 70% company's and 30% ours share. While disbursement they gave didnt give as per the commitment. we spent a lot on his operation, and request you to kindly get what is the rightful amount. thank you rajyashree [protected] mumbai [protected]@hotmail.com
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                Resolved
                The complaint is marked as resolved when a company has responded to the complainant, addressed his or her dissatisfaction, and came to an agreement where both parties agreed that the complaint is indeed resolved. However, a complaint can be automatically marked as resolved if a complainant isn't responding or updating a complaint for 30 days after the company has tried to reach the complainant.
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                Resolved
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                Dear Sir / Madam Good Morning Hope you are doing good I had filled a claim for my hospitalisation with RAKSHA TPA, Insured with Oriental Insurance Company. Claim had original hospital bill. I have completed my surgery on May1st 2014 in Navsari Gujrat with Dr Snehal Desai Hospital, handover all the original bills including cheque to my agent Mr Ganesh K Khanvilkar Dated : 7th May 2014. Am regularly following up for my mediclaim which is now almost more then 5 months till now their is no reply from Oriental Insurance Company and Raksha TPA My Policy Number : 121700/48/2014/4539 Claim Number : 556214/150/25061 Raksha TPA Number :[protected] Nobody even care to pick up the phone ) I be grateful if you can consider my application & help me out with the best possibility way very urgently, I have also enclosed attachment of my claim with Raksha TPA Stamped Mine Contact Number : +[protected] Email Address: [protected]@gmail.com Thanking you Best Regards Vispy C Master
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                Aug 14, 2020
                Complaint marked as Resolved 
                Dear Sir / Madam


                Good Morning


                Hope you are doing good


                I had filled a claim for my hospitalisation with RAKSHA TPA, Insured with Oriental Insurance Company.
                Claim had original hospital bill.


                I have completed my surgery on May1st 2014 & handover all the original bills including cheque to my agent Mr Ganesh K Khanvilkar ( +[protected] Dated : 7th May 2014.


                Am regularly following up for my mediclaim which is now almost more then 5 months till now their is no reply from Oriental Insurance Company and Raksha TPA


                My Policy Number : 121700/48/2014/4539
                Claim Number : 556214/150/25061
                Raksha TPA Number :[protected] Nobody even care to pick up the phone )
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                  Resolved
                  The complaint is marked as resolved when a company has responded to the complainant, addressed his or her dissatisfaction, and came to an agreement where both parties agreed that the complaint is indeed resolved. However, a complaint can be automatically marked as resolved if a complainant isn't responding or updating a complaint for 30 days after the company has tried to reach the complainant.

                  I purchased on line smart health Insurance policy (Rs.500000 coverage) no. J0002708 from Bharti Axa General Insurance Co. Bangalore, for my son Vishwanath Kamble. Policy start date 03.12.2013 and valid up to 02.12.2014.I admitted my son to Hospital(Purohit Clinic, Panvel) for right soulder dislocation problem, to carry out the surgery. We submitted required papers from Doctor to TPA, Emeditek, Gurgaon, Haryana for prior approval to carry out surgery. All clarifications/justifications provided to TPA (Emeditek) & Bharti AXA GI, Bangalore wide emails from hospital. Surgery carried out on 29.07.14 & was in hospitalized up to 31.07.14. TPA & Bharti Axa Co. requested to submit final bill (Rs.78000) from hospital with discharge summary. Everything required documents submitted to both of them on 31.07.14. First of all both parties were refusing of receipt of documents & every time when we call them, there was no satisfactory reply from them. I was continuous on phone with them for 4 to 5 hours to trace out the submitted documents to both parties. After lot of follow up finally they refused the claim & sent a email to Hospital to recover all bill from patient Vishwanath Kamble. It was surprise to me at the final moment they refused my claim. when we put all papers for claim on 27.07.14, they have not told that we will not get the claim. till final moment they asked all papers, bill, health summary, & we given all clarifications. I am very upset due to such type of behavior of this health Insurance Co. & TPA & caused lot of mental upset to arrange Rs. 78000 from others to pay bill of hospital at the last moment.I would like to highlight to other persons/public beware from such type of Co. & TPA, those who are cheating to innocent peoples. when we apply for policy, they will not come out their policy drawback, terms & conditions.But when we pay an amount for policy to them then, they words the policy as per Co.benefit terms & conditions, which are all against to general public who buy the policy. Request to look into this case seriously, so that other innocent poor, middle class people will not be cheated in future.
                  Aug 14, 2020
                  Complaint marked as Resolved 
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                    Resolved
                    The complaint is marked as resolved when a company has responded to the complainant, addressed his or her dissatisfaction, and came to an agreement where both parties agreed that the complaint is indeed resolved. However, a complaint can be automatically marked as resolved if a complainant isn't responding or updating a complaint for 30 days after the company has tried to reach the complainant.
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                    Resolved
                    The complaint is marked as resolved when a company has responded to the complainant, addressed his or her dissatisfaction, and came to an agreement where both parties agreed that the complaint is indeed resolved. However, a complaint can be automatically marked as resolved if a complainant isn't responding or updating a complaint for 30 days after the company has tried to reach the complainant.

                    This is the very worst experience with the Heritage Health - Chennai centre.

                    - Not responding in the standard manner and they do not know how to speak with the customers who are discussing important matter.

                    - Always having an objective to cut the call rather than resolve or answer the query.

                    - For the past week, I have called around thirty times to resolve a single query but still I didn’t get a proper reply from them.
                    Aug 13, 2020
                    Complaint marked as Resolved 
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