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[Resolved]  TOCE — Discrepancy and Delay In My Claim Processing

This is with reference to my claim submitted for reimbursement of expenses incurred towards my mother's treatment, under medical insurance scheme of TTK Healthcare Services for the policy no. 4034/FPP/02581584/00/000.

I submitted two claims, of total Rs 13131, with all the bills and other necessary documents, first on 4th November 2008 of Rs.3800 and second on 14th November 2008 of Rs.9331. I also got an acknowledgement by phone, for submission of claims, from the customer care person. I got the response for the first claim is 'REJECTED UNDER HOSPIALISATION LESS THAN 24 HRS'. As per the law it is not required to go for 24 hr hospitalisation for certain cases like bone fracture.For this i have the doctor certificate and i can submit if required.

The response for the second claim is " UNDER VERIFICATION". Since then I called up their office many times, for update on the claim processing but did not get any satisfactory answer. The customer care executives there failed to give me the correct status of the claim being processed in any of my call. Sadly, I have not got any communication from TTK Healthcare Services in this regard so far as well. After more than a month has passed, I am still waiting my claims to be processed and the requested amount to be reimbursed to me.

I have not got any response so far. Nothing has been done till date.

Please look into the matter at highest priority otherwise I might need to take some other strict action for this matter.

Looking forward for your response.

Complaint marked as Resolved Aug 14, 2020
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