[Resolved]  United India Insurance Co. — Refusal of my Mediclaim ny United India Insurance Co. & TTK Health Care TPA Pvt. Ltd.

Address:

North 24 Parganas, West Bengal

Dear Sir,

With due respect I would like to draw your kind attention which are as follows :-

I, Sri PRANAB KUMAR DEY is suffering from “Colone Cancer” since last 2004, right now my treatment is going on under the guidance of Dr. G.S. Bhattacharya (MD In-Charge of Medical Oncology, AMRI Hospital) (Member of National Cancer Control Programme, Govt. of INDIA), Member (Task Force) ICMR, Govt. of INDIA, (Advisor, Dept of Science & Technology, Govt. of INDIA).

Sir, I have done my Mediclaim Policy in the year 2005-06 (under Arogya Raksha Mediclaim Policy) through “INDIAN BANK” of 36/1, Vivekananda Road, Kolkata – 700 007. Please note my Policy is with “United India Insurance Co. My Policy No. 2009/[protected]/1, My TPA is TTK Health Care TPA Pvt. Ltd.

Please be informed that I have gone through two major operations of “Cancer” which was done by Dr. A.P. Majumder, in the year 2004 & 2008 respectively in S.V.S. Marwari Hospital, 118, Raja Ram Mohan Roy Sarani, Kolkata – 700 009 & AMRI Hospital, Kolkata. Dr. A.P. Majumder is the M.S. Dean Oncology, AMRI Hospital, Dhakuria, Kolkata.

Sir, it is also for your kind information that since the activation of my Policy i.e. from Last 2005, I have not submitted any claims, irrespective of various difficulties arose in my life. Sir, on 21.12.2009 morning, I had taken admission in AMRI Hospital, Dhakuria (P- 4 & 5, C.I.T. Scheme – LXXII, Block – A, Gariahat Road, Beside Dhakuria Bridge, Kolkata – 700 029) for taking ‘Chemotherapy’ as per the advice of Dr. G.S. Bhattacharya, and before taking admission I submitted the necessary Mediclaim form which was duly filled-up by me along with other relevant documents for availing the “CASHLESS BENEFIT” through Proper channel, as per the rules of the AMRI Hospital.

Sir, I regret to mention that my appeal was out rightly rejected by the Mediclaim Authority saying “it is a Pre-existing diseases” (irrespective of Hon’ble Supreme Court’s advice in this regard i.e. Pre existing disease must be granted if it is a non claim y continuous policy upto 4 years from the insertion of the policy & also the policy should be flawless/without break upto 4 years). Secondly the Mediclaim Authority also mentioned I have discontinued my Policy at the time depositing the premium during the 4th year, hence it is not a flawless policy.

Sir, the fact is I have deposited my Premium in time/within due date with the INDIAN BANK (ready to submit necessary papers and letters of the Bank).

Please note, if some delay / miscommunication would have occurred then it was not happened from my part (ready to submit copy of the Bank letter in this regard).

Sir, on my part my Mediclaim Policy is a continuously insured /renewed & flawless, non claimed Policy. Hence I am completely eligible to avail the “CASHLESS BENEFIT / REIMBURSEABLE TREATMENT”, as because I am a non-claimer Mediclaim Policy Holder since the insertion of my policy i.e. from last September 2005.

Sir, as you know that treatment of “Cancer” is very very expensive, which I am taking since 2004 without any Mediclaim help till date.

At this juncture I would like to request you to kindly take up my matter with “INDIAN BANK 36/1, VIVEKANANDA ROAD, KOLKATA – 700 007 and to the CHIEF MANAGER, INDIAN BANK, 1 B. BANCASSURANCE SERVICE CENTRE, 66 RAJAJI SALAI, CHENNAI – 600 001, also it would be very kind of you if would please take up this matter with TPA M/s. TTK Health Care Services (P) Ltd. (email id : [protected]@ttkhealthcareservices.com) also kindly take up the matter with “UNITED INSURANCE CO. LTD. Chennai, so that I can avail the facility of Mediclaim.

Sir, lastly I would like to appeal to your goodself, please help me to Survive a few more days without giving more pains to my aged Parents.

Awaiting your sympathetic early reply, Sir.

With regards,

PRANAB KUMAR DEY (Patient)
Mobile No. : +91 [protected], +91 [protected]
Email : [protected]@yahoo.com & [protected]@yahoo.co.in
Residential Address :
C/o. Sri Rabindra Nath Dey
2/2, Dr. Jiban Ratan Dhar Road,
Dum Dum, Kolkata – 700 028