[Resolved]  National Insurance Company — not received the claim against policy no[protected] of health insurance policy since january 17

Address:

401107

Dear sir/ madam,
I am bhawna gupta, a lower middle class women staying in mumbai. I got really frustrated with this national insurance company and especially with there tpa “med save health care tpa ltd mumbai “ contact number[protected], contact person: mr. S. N shetty (Regarding the claim of rs 27500/- against my health insurance policy no[protected] which the tpa and the company is delaying for unnecessary reasons. Now finally i decided to write to you and request you to take a strict action against this insurance company and its tpa. The brief of my case are as follows. I have been admitted in a hospital in emergency for 5 days i. E. From 21-dec-2016 at 9.00 pm to 25-dec-2016 because i was suffering from burning and heavy pain in lower abdomen with heavy fever (103 f) (As prescribed by the doctor). I have informed about my admission to the concerned authority by making a call as well as in writing through the mail. After relieved from the hospital i have submitted all the documents on time i. E. My detailed file of hospital, medical report and medical bills. After 25 days of submission of my documents i started following with the tpa med save team and every time i got the answer that the file is under audit. Then finally almost after one and a half month of my follow up i got the answer that my claim has been rejected, when i asked for the reason they have not provided me any proper reason and when i asked them to give the rejection letter in writing, they simply refused to do so. Then by the help of my contacts i finally got the number of mr s n shetty, the senior person over there in tpa, i talked to him about my case and message him all my details on 17-03-17 and went to meet him on 18-03-17 along with my husband. But he was very rude to us, i have again submitted copy of all the related documents which he asked i. E my leave card from my office and a letter assuring that i was absent from the office on the days i was admitted in the hospital signed by the ceo (Mr prakash raut) and director (Mr jimmy parikh) of my company i. E commander watertech pvt ltd. He also made me write a letter in front of him that i have submitted all my documents and was admitted in a hospital and was seriously ill. He also took office card of my husband from him and have also asked me to produce a proof of intimation to national insurance when i was in the hospital and i have produced that also. He assured me that he will look into the matter himself and will help in releasing my mediclaim on asap basis but it has been six months past when i met him and have not received any reply from his side and whenever i call him for the same he either don't take the call or if received by mistake then always reply me by saying that he is in a meeting and will reply me later and that later never comes. My husband has also given him a reminder call for the same in the month of may june and july 2017, but has never received any reply from his side. I request you to, kindly look into the matter and take necessary action against the insurance company and help us to get our hard earn money as we are in financial crises. Thanks & regards,
Bhawna gupta garg