Medsave Healthcare (Tpa) Limited — medical insurance claim file no. 20190216b016rh11130 policy no. [protected]p[protected]

Address:

4, Stone Link Avenue, Raja Annamalai Puram, Chennai 600028, 600028

Dear medsave team (Service provider)

I, kandasaami mohan, a practicing advocate after retiring from a corporate company have been a policy holder for my parents in united india insurance company for over 15 years. I have been paying my premiums regularly on time. I filed a claim on 26.04.2019 for rs.3 25, 000 after spending over rs.400000 on her hospitalization and today on 26.08.2019, the claim has been pending over 120 days.

I have sent 23 mail so far and made over 50 phone calls. I am told that claim is pending for investigation as the claim was higher. This investigation was going on for close to a month. Then the paper the paper is to be scrutinized and their medsave.in site says that this was completed only on 12th august 2019.
The approved amount is pending with finance for over 15 days and now it is still lying for the final signature and transferring the amount to my credit. The very purpose of having insurance gets defeated and more so in my case there are very few specialists and very few bigger hospitals in a place like trichy, tamilnadu and the kaveri medical center, one of the big hospitals does not come under cashless program with medsave. It is time that government should bring out regulations ensuring settlement within a short period of time, say 30 to 45 days and if there is any delay the insurance companies should be made to pay 10% interest over the 45 days period. Let us assume a situation that the policy holder has taken a loan at 15% and the settled amount normally would only be 60% to 70%. You can calculate where the policy holder ends.
Also while settling the claim the company should clearly state as to why the entire amount has not been paid with details so that if the policy is aggrieved, he or she can take up the matter to different levels for suitable action. To make the long story to one sentence, theses companies are run with policy holders money but when it comes to the question of settlement policy holders are treated differently. You are dealing with human beings and their comfort and hence speedy clearance of claims is a must in every case.

Kandasaami mohan
Chennai 600028