Medi Assist India — CLAIM NO[protected]Oriental- under policy - 412291/48/2021/24

Address:

chennai

PLACE: CHENNAI
Date[protected]
TO
M/S MEDIASSIST TPA LTD
NELSON MANICKAM ROAD
CHENNAI -600 020

Dear Sir/Madam,
SUB: REQUESTING –CLAIM settement
REF : CLAIM NO –[protected]Oriental-
under policy - 412291/48/2021/24

I am also Oriental Insurance and LIC Agent Since 2001. I have made many Remainder and Explanations to you. I came to know that you rejected my claim.

You have made major mistake in processing in data in your systems

Error # 1

Date of Admission Errors in Insurer concurrence

I found that major errors on submission for concurrence approval to the insurer . I request you to check and modify the same.

1. Date of Admission
2. Date of Discharge
3. My state of Health

You haven’t stated my health to Insurer in your concurrence mail.

Explanation # 1

In company policy schedule, there is no parameter for time delay in stipulated period for admission.

(Schedule Enclosed)

Explanation # 2

Reason : Time Delay for Admission - No beds available.

I have explained calendar of from sample to discharge from Hospital.

(Calendar Enclosed)

Explanation # 3


Reason : For Admission – Symptoms of ailments.

I got suffering and following issues started increasing day by day as follow.

1. Head ache

2. Breathing issue

3. Tasteless

4. Smell-less issue.

5. Lack of intake food and water

6. Weakness

I had decided to admit hospital then. This was reason delay in hosipital. This is my life and body and I admitted in hospital. I have to live for family.This is my rights to get treatment irrespective of claim matters.

(Discharge summary Enclosed)

Rising Issue :1

COVID-19 Test on 5 April 2021 Negative. Why Hospital ?

I admitted in hospital on 4th april 2021 at 9.40 am.

The sample was taken on 5 th April 21. I couldn't get results till my discharge. Even, treated Doctor did not know the result. I was treated Covid-19 treatment from hospital from Admission to Discharge.

When I received Discharge summary, they given Results and other copies. The original reports were submitted to Star Health and Allied Insurance Company.

Post Covid-19, After 15 days, I found food taste and identified smell .
I felt Normal Voice after 30-40 days of discharge.

My state of Health is available in Discharge summary of hospital.

Rising Issue :2

If one insurer was paid & claim accepted as per covid-19 norms.
Why can not you make payment to me which is not free cost and I have
paid premium.

Please make quick in settlement of claim. Already, it crosses 130 days more of passed from submission.

If, there is a any denial, I will go to OBUDSMAN for my rights.

Best Wishes to ALL !

Thank you

Yours faithfully

N Bharathamani