National Insurance Company — complain about non-disbursal of payment even after it is approved

Address:

Ahmedabad, Gujarat, 380059

With this letter, I am filling a complaint against New India Assurance and its TPA E-Meditek for the non-reimbursement of my mediclaim amount. I am furnishing details herewith:

Name of the insurance company: National Assurance
Claim ID:[protected]
Ins Claim Id: PG: Individual Mediclaim Policy(I )
PN: 301900/48/16/[protected]

Name of the POLICY HOLDER/PATIENT: ASHABEN J. CHHAYA AKA ASHALATA J CHHAYA

Date on which claim was submitted: 29/08/2017
Claim approval date: 09/09/2017
Claim Approved amount: Rs 218250 (Two Lacs Eighteen Thousand Two Hundred Fifty Rupees)

I received email on October 10th that my claim is approved. As I did not receive the amount in two days I called on Customer care number to inquire about it and I was told that they have rejected my canceled cheque as cheque did not bear my complete (full) name. Cheque has initials and so I have to submit a cheque bear full name. I asked them to mail me this reason but I have not received any intimation of for this till date. When asked why I was not intimated by email or SMS, the lady on phone replied that we do not inform such things and you have to follow up personally. When the premium amount is accepted with the cheque bearing initials then why the same cheque cannot be considered as the proof? I somewhere feel this is the way of an insurance company and TPA to harass customers and deliberate move to either delay payment or not pay the dues at all. This is waste of my time and mental harassment.

My agent personally went and submitted bank statement on October 12 to Mr Jignesh Panchal of E MEDITEK, AHMEDABAD but nothing happened. We inquired once again and we were given same reply so we re-submitted bank statement second time on 31/10/2017 to Mr. Neterang Shah of e-meditek (TPA). But still nothing happened and once again I inquired with him but he flatly denied that he has not received the bank statement. So I once again emailed him on 13/11/2017.

Please note that I was not informed either through mail or SMS about rejection.

On following up with Mr. Neterang Shah on phone he ensured that it will be done in a day or two. But till date, nothing has happened. Now he is not even picking up the phone call.

I request you to take up this matter.

Now please reimburse my claim amount along with the interest on the amount, Rs 20, 000 for the mental harassment and Rs 2000 for all the expenses incurred for the multiple follow-ups.

I have all the copies of emails that I have mailed to E Meditek.

I have already registered my complaint with IRDA and here is the IRDA Token Number :[protected].