[Resolved]  United India Insurance Co. Ltd. — UIIC is not reimbursing the medical claim and giving unusual reasons for the denial, and not giving proper reason for anything after long wait also.

Address:	Karnataka
Website:	uiic.co.in/home

Dear Sir/Madam,

Hi

I have got group medical policy o[censored]nited India Insurance Co. (UIIC) Ltd. from my company.

Patient (my mother) is admitted to the Vydehi hospital Bangalore on 29th of May 2013 and discharged on 22nd June 2013, I have provided/submitted all the supporting original documents in Raksha TPA Bangalore as said by UIIC Agent (Jane Carol).
As per the clause 4.3, They (UIIC) denied the medical claim reimbursement and said,
During the first two years of the operation of the policy, Gall Bladder Stone removal is not covered.
It does not mean that Cholecystectomy is not covered means removal of whole gall bladder, removal of some part of intestines and surgery of liver is not covered.

But, Raksha TPA and UIIC are denying the reimbursement claim saying this is 2 years old disease, I asked UIIC to give the proof for this but its been around 40 days, I did not receive any response mail from them.
UIIC and Raksha TPA are saying that removal of stone from the Gall Bladder will not be covered,
But here whole Gall Bladder, some part of intestine and they operated liver as well. Why this will
not be covered. Second it is not kidney stones removal.

I followed them up so many times, wrote so many mails but did not receive any proper response. Very worst service provided by UIIC.
I did not had any option and do not have so much time to follow up them everyday, I have so many responsibilities and work also. I waited for so long but did not even get any call from agent o[censored]IIC, they just said your claim denied but why it has been denied ,UIIC is not giving me the proper reason of denial. They just don't want to reimburse the claim, it is there policy which changes based on the case.

I need the justification of denial from the UIIC. Please do the needful. I want the claim to be reimbursed if not give me the proper reason.

Regards....

Employee: Amar Nath Verma
(Client name: Chimera Technologies)
Member ID No.- UIC54586CHIM