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[Resolved]  Health Shield Mediclaim Policy With Royal Sundaram — Not Getting Claim

I was fall in sick and got admitted in “Jeevan Deep Nursing Home”, Burdwan, West Bengal which is network nursing home. But there my medical treatment was not undergoing properly due to scarcity of adequate medical facility. After few days my doctor advised me to shift urgently to other good specialist hospital in Kolkata as multi-diseases were detected and my health condition was deteriorating gradually.

Then my family paid all the bill of the “Jeevan Deep Nursing Home”, Burdwan, West Bengal in hurry and collected all the original bill. In the meantime the said nursing home send fax to Medicare for Cashless approval for my treatment.

When I was reached to “Calcutta Medical Research Institute”, Kolkata, West Bengal and they advised us to request “Jeevan Deep Nursing Home”, Burdwan to send cashless cancellation fax to Medicare. After doing so Medicare TPA gave initial cashless approval of Rs. 15000/- (Rupees Fifteen Thousand). But at the time of discharge from CMRI my total bill amount was Rs. 21519/- but Medicare TPA did not extended. We had to pay balance amount over there which embarrassed us so much. We are become too annoyed on Royal Sunderam and also to Medicare TPA where We have experience with other insurance company M/s. Star Health and Heritage TPA from United Insurance where our other family member’s cashless claim was hassle free and smooth.

I would request you to reimburse my medical hospitalization expenses and keep look after your customer service better. If I am to experience such non approval of cashless, then I might have to switch over my policy to other company which may concern of your company reputation.

Please release my claim of medical expenses in Jeeven Deep Nurshing Home and balance payment of Calcutta Medical Research Institute.I am feeling very disappointed about your service and claim settlement system. From nex year onward I will switch over my mediclaim policy to other company.

Sadhan Kumar Dey
Complaint marked as Resolved Aug 13, 2020
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