National Insurance Company — Denial of my Legitimate /valid /Permitted( as per health policy document ) Reimbursement claims

I(Spouse ) Ravish Vasant Dhebri Age 76+ as Patient, My wife Vijaya R Dhebri Age 71+ Primary Insured by Bank of Baroda Her EC no 142134 vide GHI Policy for Retirees. Policy[protected] year 21-22.I am undergoing Chemotherapy treatments every month for my Urinary Bladder Cancer at Deenanath Mangeshkar Hospital Pune. My July 22 &Aug 22 Day care treatments are denied by National InsCo Corporate regional office Mumbai mentioning clauses 2.10, .2.19. & 3.3.I have in detail Read Policy Document (Policy No[protected] as mentioned above ) total pages 26.between Bank Of Baroda Head Office, Baroda Bhavan Alkapuri road Baroda.and National Ins Mumbai Regional Office Churchgate. clause 2.10 page 3, 2.19 pg 4 &3.3 pg 9 shows 36 Trmnts permitted as Inclusions for Day Care Trmnts in which Chemo trmnt is at item no 13. TPA Medi Assist have Violated these framed rules & rejected my claims Claim Nos 29115030 for Rs 05913 & 29514718 for Rs 03854 total09767/-I have already Paid full charges to the Hospital.Kindly Review this Legitimate claims and clear my claims to Prevent my Financial Loss at this Retired Age.Pl Pay my Reimbursement by NEFT in my Bank of Baroda Sadashiv Peth Pune 30 Branch .Earlier chemo Trmnts from nov, Dec 2021 total Six Were Paid by National Ins co Mumbai in my acct by Neft.without any Denial by TPA Medi Assist. Do not understand why they have Denied Now.
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National Insurance Company customer support has been notified about the posted complaint.
Dec 22, 2022
Updated by Baba two
MY Complaint ID 3362857 as per EMail dtd 14Dec22 from National Ins Co Mumbai NOT Replied/Resolved till 22Dec2022. I Request National Ins Co to resolve Urgently & Prevent my Financial Loss
Jan 31, 2023
Updated by Baba two
Urgent Action by National Ins Co Corporate Regional office Mumbai is Requested as my Complaint UNRESOLVED For last One and Half Month. I have already Paid Full Hosp Charges in Aug 2022.
Pl reply on Email [protected]@yahoo.co.in
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My Complaint ID 3362857 Dtd 13 Dec2022 NOT YET RESOLVED. Pl note my Reimbursement Claim is Valid & Legitimate as per details given in my Above complaint. I Request NAT INS CO Corporate Regional Office Mumbai to Revoke my claim Denial by TPA Medi Assist ( Year 21-22 ).Also please note that this Claim for Rs 09767/-of July 22& AUG 22 are 7th & 8 th for my Day Care Chemo treatments, TPA Medi Assist have passed my earlier 6 claims of Day Care Chemo treatments .I am sure Nat Ins Co Mumbai have Powers to overrule TPA 'S Denial as my Reimbursement claim is as per Policy Document as mentioned in my 13 Dec 22 Complaint .Pl prevent my Financial Loss.
NO REPONSE From National Ins Co since 13 Dec 2022
Pl reply on my E Mail I D [protected]@yahoo.co.in
I expect Early Resolution from SR Officers Of National Insurance Co Corporate Regional Office Mumbai with whom Bank of Baroda HO, Baroda Bhavan Alkapuri Baroda G H I Poilcy For Retirees is done for year 21-22
My Complaint of 13 Dec 2022 . I was informed that compliant will be RESOLVED IN WEEK'S Time .But .Almost Three Months over NO RESOLUTION AS YET. My complaint is Not Given for Records/Library Storage but for Resolution in Time Bound Manner. I DO NOT Find /See any Concrete Actions being Taken .I have earlier given Two Comments No Response to This Also. National Insurance Co Have to give " Assurance to Policy holders "who have Paid Large Premium that valid/legitimate claims will be Reimbursed without Delay.
My December 2022 complaint for valid/legitimate Reimbursement Not Resolved till 06 April 2023

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