Md India Health Insurance Tpa Pvt Ltd — Non settlement of claim

Address:

Patna, Bihar, 800001

Dear sir,
Through this mail, i would like to draw your attention towards my reimbursement of my claim against happy family floater health policy:
That the policy was purchased from oriental insurance pvt. Ltd. Patna.
That the policy was continued from the year 2011.
That the policy is issued in favour of madan dubey and sangita dubey.
That the policy number for the year[protected] is 331103/48/2017/1708
That the name of tpa is md india health insurance tpa pvt. Ltd.
That before admitting in the nursing home i intimated the tpa md india that very soon sangita dubey is going to be admitted for eye operation at vijya eye hospital and clinic patna.
That after intimation i got claim number mdi 3209488 from tpa.
That after getting claim number on dated[protected] sangita dubey was admitted for an eye operation at vijya eye hospital and clinic. The operation was done on[protected] and on[protected] she was discharged from the hospital.
That after discharge on dated[protected] i submitted all the relevant paper of rs.28189.00 to md india patna office.
That on[protected] i got the message through sms and mail to provide the attested photocopy of valid hospital registration certificate - with mentioned registration number with expiry date registration certificate & the number of beds.
That after getting instruction i met with doctor and requested him to provide above written papers to settle the claim.
That after knowing the matter the doctor told me he will not provide the paper to me. He also told me that if insurance company needed this paper they should directly contact him.
That the fact is it is the case of an investigation. If tpa wants to know the fact he has to appoint investigator and enquired the matter.
That when i contacted customer care they told me to provide the paper otherwise they will reject the claim.
In this regard, i am requesting you to please look into the matter and give me justice because as a consumer how can i pressurise the doctor to provide registration paper and before operation or admission how can i demand to doctor's and his nursing home's registration papers.
Waiting for justice.
Regards

Madan dubey
Advocate
Patna
Ph. No.[protected]

Click here to reply or forward