Oriental Insurance Company — policy no. 252400/48/2019/2000. partial payment in cashless insurance
Meerut, Uttar Pradesh, India
Vivishaltomar2002 on Nov 12, 2018
Sir mrs saroj tomar resident of 205 sheel kunj roorkee road meerut is insured under mediclaim policy from oriental insurance for rupees 500000.
she was admitted in fortis c-doc hospital b16 chirag enclave new delhi on 5th october 2018 under supervision of dr subhash shalya.
She was discharged after treatment from the hospital on 15th october 2018, at the time of discharge the tpa that is raksha health insurance refuse to pay the complete amount from the total bill of rupees 325251 the tp sanction the amount of rupees 285221 hence. Rupees 40030 rupees was to be paid by me while the insurance was cashless.
two days delay in surgery and one day post surgery admission is properly justified by dr subhash shalya how could the tpa deduct the amount while the insurance is cashless.
the points which are objectionable r are 1. rent of three days rupees 8400.
2. All investigations rupees 14736.
3. Doctor charges for the three days 9600 rupees. 4. Diet charges 5500 rupees total 38236 rupees.
sir i request you to look look into the matter and order the insurance company or tpa company to pay rupees the aforesaid amount that is rupees 38236.
Otherwise i will have to move to the honorable court.
Copies of bill and justification letter by dr subhash shalya is enclosed with the mail
[Nov 12, 2018] Oriental Insurance Company customer support has been notified about the posted complaint.
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