National Insurance Company — partial claim settlement of patient name karishma gupta card no.: [protected]e emp. code: 98- medsave
Greetings of the day.
I would seek your help in the following matter:
I would like to inform you that i had submitted healthcare expenses claim of my daughter (Karishma gupta) on 8th nov'2017 to your national insurance company office at malad (W) against our policy no.[protected]. The claim included healthcare expenses incurred during jan 17, mar'17 & aug/sept'17 of rs. 1110, rs.910 & rs. 2965/- respectively (Totalling to rs. 4985/-)
I have received only rs 2965/- along with final settlement claim from our tpa medsave (Attached for your reference) wherein partial claims of rs 2020/- of jan17 & mar17 have been disallowed on account of 'bills after 15/30 days"
I would request you to refer to your attached policy (Pages 1 to 6).
As per clause no 5.6.4 of your policy (Pg 5 & 6)," the claim documents of healthcare expenses has to be submitted at least 45 days before the expiry of 4th policy period".
The policy does not indicate the following:
1. Documents have to be submitted within 15/30 days as mentioned by your medsave manager mr shetty through attached final settlement.
2. Health check reports cannot be clubbed and submitted at a time.
As the healthcare expenses of all the above three periods of submission of my reports meet your above policy, you are humbly request to re-reimburse them at the earliest.
Further i should not have received even rs.2965/- as bills were of aug/sept'17 and submitted on 8th nov.'17 which also should have been disallowed on account of 'bills after 15/30 days"
I would appreciate you to confirm the total payment by an email.
[Mar 15, 2018] National Insurance Company customer support has been notified about the posted complaint.
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