| Address: | 400080 |
| Website: | Medsave TPA |
I (along with my daddy) am holding National Mediclaim Policy no.[protected] since more than last 15 years.
My daddy (total sum insured - Rs. 1, 50, 000/-) was operated for retention o[censored]rine due to prostate enlargement on 24/02/2017.
i incurred total cost of Rs 79, 596/-, which I promptly claimed from Medsave TPA.
The TPA has reimbursed Rs. 65, 123/- and has arbitrarily deducted a total of Rs. 14, 473/- from my total claim of Rs 79, 596/- without giving any valid reason.
While deducting doctors' charges they have mentioned - exceeding Catg B Limit (25% of the sum insured), but they havn't even reimbursed Rs. 37, 500/- ( i.e. 25% of 1, 50, 000/-) in that category.
They have also deducted instrument charges of Rs. 5000/- charged to me by the hospital, which I have paid from my pocket. Rejecting that as 'Instrument charges part of OT' is illegal, arbitrary, unfair and is just an excuse to cut corners. If you want to consider it as OT charges, please consider it so. But it needs to be reimbursed to me.
The TPA has not even bothered to respond to my 3 mails and reminders, which is very unprofessional.
Kindly look into the matter and reimburse me the same ASAP, lest I may have to escalate the matter to IRDA.
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