| Address: WZ-79/C-1 second floor, Gali No. 08, varender Nagar, New Delhi 110058 |
With regard to the above subject, I am addressing the whole incident with respect to claim no. NI-3-80079. My wife Jaswinder kaur was admitted to Karla Hospital on dated 12.08.21 and discharged on dated 18.08.21, total claimed bill amount was Rs. 197153/- authorized amount was Rs. 152500/- and amount paid by the insured was Rs. 23065/-
Our TPA M/s Safeway insurance TPA pvt Ltd, deducted the following amount which is not acceptable to us, however the same is in line with the treatment. Duty doctor has already recommended the same.
Consultant Visit Rs. 3500/- Reason for deduction Ortho Consultation Irrelevant.
Investigation (Radio + Patho) Rs. 14170/- Reason for deduction Vitamin, CT Wrist Knee, Viral Marker, Glucometer, Thyroid, etc
I had submitted the case for refund of said amount to Safeway TPA along with relevant documents and doctors recommendation, but they refused the claim and only reimbursed the post discharge medical bills worth Rs, 9500 approx.
My only request is to please look into the matter personally and reimburse the amount of Rs. 17670/- immediately, as the same is relevant and in line with the treatment or else I will address the same to grievance.
Your prompt response would be highly appreciated.
National Insurance Company customer support has been notified about the posted complaint.
THEY REPLY JUST PAYMENT NOTIFICATION BUT NOT RESOLVE ABOUT WRONG DEDUCTION.
They have no any cashless hospital in Bharuch and deduct amount as none network hospital from may paid amount. How is it possible .Network hospital not available so we treat my son with None network hospital. Second National insurance not responsible for this .National insurance divert this matter to TPA. We concern to National insurance not to TPA. But some Hospital Tag National insurance Board for CASHLESS facility, we are not able to under stand how is it possible.
Request you to help me.