Mdindia Healthcare Services — Not Fully Reimbursing the Expenses by stating irrelevant Telangana GO

Address:

Hyderabad

My father Mr. T. Sreehari was appointed in Sunshine Hospitals, Secunderabad on 06.08.2020 for treatment of COVID 19 and was discharged dead on 15.08.2020. The total Bill amount was Rs. 909, 000/-. I'm having a Family Floater policy with New India Assurance Co with a limit of Rs. 5 lakhs. I submitted claim of Rs. 909, 000/- along with hospital bills and other required documents for reimbursement with MD India TPA vide claim no MDI5766939 for MD ID No. MDI5-[protected].

My claim was however settled for only Rs. 318, 737/- with a deduction of Rs. 590, 263/- out of which a deduction of Rs. 376, 392/- was made stating as per Telangana GR deduction done.

Upon enquiry it was known that the Telangana state govt GO No 248 of 2020 was relied upon by TPA. I bring to your learned notice that the said GO was issued by Govt of Telangana fixing a cap on the COVID 19 treatment cost by Private Hospitals. The Insurance companies and TPA are no way connected/concerned with the said GO.

When the hospital itself is providing bills stating that theyhave collected more than the said GO and we have cleared the payment. The TPA and Insurance companies were in no place to fall upon the said GO to make such hefty deduction. The said GO is not addressed to Insurance companies or TPA and it does not provide any guidance to settle the hospital claims.

I therefore request you to kindly reverse the said deduction and settle the amount in full.