[Resolved] New India Assurance Company / Mediclaim Policy — Discrepency In Acceptance Of Mediclaim | |
I hold a mediclaim policy with The New India Assurance Company for my mother. Mem No.: 02I00257923B Policy No.: 511600/34/08/11/00003362 My mother was admitted in AMRI Hospital, Kolkata for a surgery. The total Bill for the hospitalization was Rs. 1, 37, 825/-. On submission for "cashless" claim, the total permissable claim granted by "Medicare TPA Services (I) Pvt Ltd". Kolkata was only Rs. 50, 000/-. Although the insurance cover for the above mentioned policy is Rs. 1, 50, 000/- with accumulated bonus of Rs. 50, 000/- for 1st 1 lac and Rs. 2, 500/- for next Rs. 50, 000/- The logic given is that all expenses will be reimbursed basis permissible room rent. Now, if permissible room rent is Rs 1000/- and the actual room bill is Rs. 3000/-, then even surgeon fee would be reimbursed only to the extent of 1/3rd of the expense. Sounds pretty irrational. Was this information helpful? | |
Aug 14, 2020 Complaint marked as Resolved | |
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