Max Super Speciality Hospital East Wing - A, Unit Of Devki Devi Foundation Saket, New Delhi - 110017 — tpa and reimbursement delays

Address: MAX Super Speciality Hospital East Wing - A, Unit of Devki Devi Foundation Saket, New Delhi - 110017

To
The Manager,
Customer Relations Department
MAX Super Speciality Hospital
East Wing - A, Unit of Devki Devi Foundation
Saket, New Delhi - 110017

**Subject: Complaint regarding repeated issues with TPA and reimbursement delays**

Dear Sir/Madam,

I am writing to formally express my deep concern and dissatisfaction regarding the repeated issues I have faced at your hospital with the TPA department in relation to timely claim processing and reimbursement procedures.

**Patient Name:** Baby Tabassum
**Policy Number:** [protected]
**Claim Intimation Number:** CIR/2026/231119/0447617
**Date of Admission:** 23-Jun-25
**Date of Discharge:** 23-Jun-25
**Insurance Provider:** STAR Health and Allied Insurance Co. Ltd.
**Diagnosis:** CA Left Breast

While the final bill of ₹14, 584 was raised, only ₹11, 648 was approved by STAR Health. The remaining amount was to be borne by me due to reasons listed in the approval sheet. However, the problem does not lie in the amount deducted, but in the **recurring pattern of negligence and unprofessional behavior exhibited by your TPA department**.

Every time I or any other patient visits your hospital for treatment under insurance, we are subjected to undue delays and **non-cooperative behavior from the TPA staff**. The staff consistently fails to initiate or follow up on claims in a timely manner, leading to unnecessary stays and mental trauma for patients. Worse still, **patients—especially those who travel from outside Delhi—are forced to make repeated visits to the hospital just to request reimbursement or get updates.**

On multiple occasions, I have been **humiliated and spoken to rudely** by the TPA personnel, who seem indifferent to the needs and condition of a recovering patient. Despite your hospital collecting advance payments under the assurance of smooth cashless treatment and timely reimbursements, **the burden of coordination and follow-up falls entirely on the patient**, which is extremely unfair.

I request that this complaint be taken seriously, and a formal inquiry be initiated into the conduct of your TPA department. I also urge you to put in place a **standard operating procedure to ensure patients are not made to suffer emotionally and financially due to internal mismanagement.**

I would appreciate a written acknowledgment of this complaint and information on the corrective steps taken.

Thanking you,

Yours sincerely,
**Dr. Tabassum**
(Policyholder)