New India Assurance — Mediclaim reimbursement;POLICY NO[protected], CLAIM NO[protected];

My grievance pertains to my legitimate expenses being disallowed in my claim for reimbursement of medical expenses.
I was hospitalised on 18/04/2021 for acute and chronic pancreatitis and discharged on 19/042021. The discharge summary is attached..
I submitted a claim for reimbursement of my medical expenses for Rs 12530/- to HITPA vide my letter dated 27/04/21. Of the claimed amount, only Rs 5155 was approved for reimbursement. Legitimate expenses have been disallowed.
The three disallowed expenses that I have protested about are as follows:
1. Room rent Rs 2800/-. This has been disallowed, even though I was hospitalised, for the reason "room ch (not payable in pre-post)". I have repeatedly requested that this amount should be cleared as I was admitted in hospital but to no avail. Attached is the hospital bill.
2. Consultation Charges Rs 1500. The reason this has been disallowed is because "RS 1500/- consultation paper dated 18-19 april 2021 not attached". These are charges that are raised when Doctors visit patients in their rooms/wards during their rounds. There is no practice of written reports for each and every consultation that a Doctor has with different patients during his rounds. My repeated representation that this expense be allowed has not been accepted. Kindly refer to the hospital bill attached.
3. Path Lab Bill of Rs 2200/- ( Kindly refer to the Hospital Bill attached).This expense pertains to the pathological tests that were done during my hospitalisation. The discharge summary states "Relevant investigations were done".This expense has been disallowed even though the lab reports have been furnished. The reason given is that no prescription for these tests has been given. These were tests conducted by the hospital for a patient admitted therin on the instructions of the Doctor. Where is the question of the doctor writing a prescription for such tests? My representations have not yielded any fruit.
I am aggrieved that legitimate expenses have been disallowed. I request that my grieance be taken up and HITPA be advised to pass these expenses.
(Documents could not be uploaded because of memory constraints)
Was this information helpful?
No (0)
Yes (1)
New India Assurance customer support has been notified about the posted complaint.
Complaint comments 

Post your Comment

    I want to submit Complaint Positive Review Neutral Comment
    code
    By clicking Submit you agree to our Terms of Use
    Submit
    New India Assurance
    customer care contact
    Customer satisfaction rating Customer satisfaction rating is a complex algorithm that helps our users determine how good a company is at responding and resolving complaints by granting from 1 to 5 stars for each complaint and then ultimately combining them all for an overall score.
    Read more
    17%
    Complaints
    694
    Pending
    0
    Resolved
    119
    New India Assurance Address
    87, M.G. Road, Fort, Mumbai, Maharashtra, India - 400001
    View all New India Assurance contact information