Medsave Healthcare (Tpa) Limited — Refund claim against medical expenses in Dr LH Hiranandani Hospital

My name is Sanghita Basu and my mother Sarmistha Basu was admitted in Hiranandani Hospital ward 504 bed 4 and had been discharged yesterday (11/09/2022) after a complex knee reconstruction surgery under Dr. Sanjeev Jain Sir. She had fallen down on a road in Pipeline Area near Sakinaka in Mumbai as she could not see the bumper. Mediclaim policy of Rs 220000 is available in her name upto 12th November 2022 after which a renewal has to be done. Her Policy number is[protected]. Our TPA is MEDSAVE. Our Mediclaim agent Mr. Ranjan Majumder working in National Insurance company in Kolkata branch (Contact number: [protected]) did not corporate us at our time of crisis. A very irresponsible agent who doesn't pick up his phone most of the time. TPA approved 90, 000 initially on 9th September and the enhanced amount of Rs 40747 was approved later at the time of discharge from hospital. A total of 130747 was approved when my mother had an assured insurance amount of Rs 220000. Around 50K was charged by Hiranandani Hospital payable at cash at the time of discharge. Got panicked, we immediately called the surgeon and he was generous enough to reduce 25000 rs and we needed to pay an amount of Rs 23655 by cash (attaching the transaction details). Now I would like to claim the amount of Rs 23655 as refund after bearing medical expenses. I have detailed bills and documents which I can submit through mails or directly at Mumbai office. If I need to pay so much after having Mediclaim policy, what is the use of having a Mediclaim policy for which I need to pay a substantial amount to you as premium? Why you have kept such irresponsible employees who doesn't pick up his phone at the crisis period? I will not renew policy under this agent and have planned to transfer the policy in hands of some other professional agent. Check the attached screenshot. Very unprofessional attitude from your side and worst experience I had for the first time with a reputed government insurance company like you. And MEDSAVE is pathetic. Neither toll free number is o[censored]se nor the official email ID. Yesterday only someone picked up the phone and told me to submit at MEDSAVE Office located near my residence. I will do that. But your resolve process is so slow and bad. I have doubt will our problems have resolvation?