Kokilaben Hospital — Mismanagement in Medical Insurance T P A and lack of knowledge / Guideline.

To, Date:[protected]
C.E.O / Management
Kokilaben Dhirubhai Ambani Hospital Indore
BCM Estate, Nipania Indore 452010 M.P. India
Res Sir/ Madam,
SUBJECT : - Mismanagement in Medical Insurance T P A and lack of knowledge / Guideline.
Ref:- Shailendra Singh Thakur, 444, Shanti Nagar Damoh Naka Jabalpur M.P.
Patient ID :- KH[protected], DOA : 19-02-23
Patient ID :- KH[protected], DOA : 14-03-23
Patient ID :- KH[protected], DOA : 16-03-23

In contest to above subject and reference, my self Shailendra Singh Thakur from Jabalpur M.P. admitted to Kokilaben Hospital Indore on[protected] for Urology Treatment under Dr Vilkas Singh. We are not resident of Indore we have come from Jabalpur approx. 550 km from Indore.
1. That the DJ stunting treatment is done after 4 days discharged on[protected], vide bill number INIPBL/23000322 Rs. 122518.32 the same was reimbursed by third party Mandke foundation.
2. That on the reimbursement we have given my Saving Account in the Name of Shailendra Singh Thakur and Savita Thakur JOINT and they have no objection in the bank account neither any issue come regarding the reimbursement and same is smoothly done.
3. That Again on[protected] as per advice of Dr Vikas Singh doctor for removal of Stone I Shailendra Singh Thakur admitted and surgery been done on 14-3-23 and discharged is done on 15-03-23 vide bill number INIPBL/23000493 Rs. 192186.42 the same was reimbursed by third party Mandke foundation.
4. That on the second reimbursement they are asking that the Bank Account of Policy holder in the first name (primary name) in the bank account on[protected] any way we have arrange the same from Jabalpur and provided the same at 8:00 pm in the Name of Savita Thakur and Shailendra Singh Thakur. And the reimbursement is smoothly done.
5. That on[protected] due to pseudomonas virus attack on urine due to Stone crushing and taking out from kidney Dr Vikas Singh said I have little dough that you may suffer from Fever from Next day but the fever come on second day on 16-03-23 as I reach home. I Consult from Doctor and as per his advice I again admitted to hospital on 16-03-23.

6. That on treatment of the same I again discharged on 18-03-23 at this time. The TPA which was dealing in Kokilaben hospital said that as per policy you have to bring the single account in the name of Policy holder is required not joint account, we will not accepted. As the place is new for us my wife left me alone in the hospital and go to the bank and opened HDFC Bank account and give the cheque without name, Then they are saying that no this will not accepted due to name was not printed in the cheque book. We said that kindly accepted the net banking account in which 10000/- amount is reflected but dealing staff said this is third time we will not accept the reimbursement and if you admitted till Monday i.e.[protected] then I will see that the same may be accepted. The TPA has rejected our request and we have to pay all the amount in cash.
7. That all the above fact are in the knowledge of all the staff of TPA,
I Shailendra Singh Thakur want to give the following information that the TPA is only entertaining the Surgery case of big amount they are not giving any weightage to the small amount. And also they are not been guided the complete policy of TPA if so the claim settled on 22-2-23 in the same bank account is not been accepted on 15-3-23 and after this also on 18-3-23 .

This is my kind request that the treatment is too costly if the medical Insurance cash less is not available then the people like me or middle class can’t afford the same. So all the fact and details which I have given is true to best of my knowledge and belief.

I request and complaint all the fact in front of the management and want to improve the same in near future. Because I on 3rd to 5th April 2023 again visit to Kokilaben hospital Indore for DJ Stunt removal. At that time the same problem I should not to be faced.

Kindly acknowledge the same.
Yours Faithfully,

Shailendra Singh Thakur/
Savita Thakur Policy Holder
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