Max Hospital — negligence of max hospital shalimar bagh delhi

Address:	New Delhi, Delhi, 110041
Website:	www.maxhealthcare.in

Respected sir

I wish to draw your kind attention towards the negligencey by the max hospital shalimar bagh

Details given below

I have visited max hospital shalimar bagh on 2/7/2018 with my child manan gupta patient id shbg218592, doctors advised me to admit the child they have doubted that child may have celiac disease as low growth and regular illlness loose motion vomiting etc

My child mr manan admitted on 2/07/2018 at max hospital shalimar bagh, i have deposited rs 30000.00thirty thousand rs before admisssion at emergency also i have shown my cashless mediclaim policy card.

Doctors start their treatment and send the required form for the claim through tpa to insurance company

Around 6-7 pm i get the news that there is a query raised by the insurance company that "" as per records child diagnosed as a c/o celiac disease in 2015, submit all consiultation papers'

Then i have visited the tpa they provided all the copy of emailed documents to insurance co for the claim, in these papers i saw that

Document named 'progress notes or medical records ' doctor given the wrong statement that child is suffering from celiac disease and ttg positive in 2015

In 2015 child is not suffering from celiac disease also no medical examination done for celiac in 2015.
Even the ttg test report was negative in test dated 07/05/2018 at sarvodaya childcare pitam pura.
First time celiac discovered after biopsy in max hospital in july 2018 i have collected reports on 14/07/2018 on 14/07/2018 i came to know about celiac.

Due to this wrong statement or we can say negligency my claim papers rejected by the star health insurance company by saying that i have hide material facts with insurance company. I again given request for reimbursment for medical expenses to insurance company but again rejected by star health in august 2018

When i have made the complaint at reception/ billing desk/ tpa desk / or to mr nandi (At shalimar bagh max hospital) and admin dept pratima ji i have not received till today proper responce. Max hospital in their one email given in written that their is a typographical mistakefrom their side, but when i request to interfere in claim matter with insurance company they denied.

The max hospital shalimar bagh is responsible for this loss. I have requested them in email also at telephone but they denied to accept their negligency also claim of loss.
Even now i have called pratima madam from admin dept max hospital (Contact no [protected]) 3-4 times after rejection of my claim, my call not picked by pratima madam.

You are kindly please look out the whole matter. Provide me solution so that the claim get approved and also not rejected by the insurance co in the grounds of concealment of facts in future.
Also take corrective action against negligent staff.
Also i have received two different bills for the same service from the hospital
Now in september slides and blocks are reviewed and result report no celiac to child it mean there is possibility of higher level of negligency by max hospital. I have given slides for further reivew... Reports awaited

Plz do the needful

Thanks
From
Abhishek gupta
[protected]