I am Parimi Prabhaker, retired Kotak Mahindra bank employee, having health insurance policy no 251100/50/20/1000324 for Rs 4, 00, 000/-
I have admitted in hospital for Covid 19 on 01-11-20, and treated.
Hospital bill of Rs 2, 91, 034/- has submitted to Safeway TPA on 02-12-20, vide my claim no NI-18-3947.
Surprisingly only Rs 1, 76, 506/- has settled against my claim amount of Rs 2, 91, 034/- dis allowing a sum of Rs 1, 14, 531/-
As I am incurred/met all the amounts from my pocket, the hospital and medicine bills are produced in the claim, and besides my policy is for Rs 4, 00, 000/- a sum of Rs 1, 14, 531/- disallowed.
The following are the major items which are disallowed, and which are not supposed to disallowed and to be settled in toto.
Amount of Rs 37, 500/- deducted towards excess consultation charges,
Rs 10, 000/- deducted towards Nursing charges as per room rent capping.
Amount of Rs 19, 750/- deducted towards drug administration part of room rent, not payable.
Amount of Rs 17, 500/- deducted towards utilities
Amount of Rs 3, 700/- deducted towards Emergency services and
Amount of more than Rs 4000/- deducted towards gloves etc.,
I request the insurance company to look into the same and reassess the SAFEWAY TPA appraisals and arrange to give credit, of the disallowed amount of Rs 114 531/- early.
Parimi Prabhaker
National Insurance Company customer support has been notified about the posted complaint.