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Raksha Health Insurance TPA Complaints & Reviews

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Last updated Feb 29, 2024
Complaints 235
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Raksha Health Insurance TPA reviews & complaints page 2

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F
firoz9637
from Kurnool, Andhra Pradesh
Nov 3, 2022
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Cashless claim

Worst service by the RAKSHA TPA as per my personal opinion yesterday i was requested for cash less intimation through network hospital at 10 am for 70k it was approved at 4pm for Rs 30k.. and after getting treatment again requested for remaining amount at 6.00pm today till now not approved and my family still sitting in hospital even hospital staff leave the hospital.....
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Nishantrb
from Ahmedabad, Gujarat
Oct 21, 2022
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Payment not settled with Hospital for cashless claim after 11 months

Address:Raksha Health Insurance TPA (P) Ltd., 1st Floor, Plot No.42, Sector 20A, Faridabad, Haryana- 121002

Claim number [protected]
Details for Member ID : UIC[protected]RMEBS And
Policy Number: [protected]P[protected]

My mother went on Knee replacement surgery for both leg last year.
Her operation was done on 9th November 2021 with cashless claim#[protected]. She got discharge on 13th Nov. 21 after claim passed by Raksha TPA. After four moths I have started receiving call from hospital that payment is not...
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P
priyanka doley
Oct 21, 2022
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Claim pending

My daughter was born on 6 May 2022 and was hospitalised in NICU for 1 day and regarding that I have submitted my bill on august 2022 to Guwahati office.Now they are saying that they have enrolled my daughter name in the month of October.I have written mails messages to person concerned but have not received any response till now...
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Dear Sir/Mam,
My name is Saurabh Thakur working in Bank of India pf I'd 211544. My father Umesh Raikwaparn died from cardiac arrest on 12th February 2022. I am a policy holder in Raksha TPA and my father was one of my dependents. To claim for hospital expenses I have submitted all the medical records to Raksha TPA raipur branch .There were some queries to which I have responded earlier and now it's been 7 months but there is no response...
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Amarnath g k
from Mumbai, Maharashtra
Oct 14, 2022
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Cashless claim not settled .

My cashless claim not settled. Still waiting very poor customer service and grievance redressal not functioning....
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Amarnath g k
from Mumbai, Maharashtra
Oct 14, 2022
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Cashless claim not settled .

My cashless claim is not settled. I had to pay amount out of my pocket to discharge my 7month baby and still i am following up with the Raksha tpa ....
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A
arun111150
Sep 27, 2022
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Refund of medical expenses Claim Reacted

Address:DEHRADUN/ LUCKNOW

MY CLAIM OF RS 7230 INCURRED DURING EMERGENCY REJECTED ON FILMSY GROUND BY RAKSHA TPA. ALL PAPERS SUBMITTED THEY ASKED ONE RECEIPT WHICH WAS SUBMITTED TOO AGAIN AFTER OBTAINING FROM MEDANTA HOSPITAL GURGAON. BUT REJECTED EVEN THEN.
AS FOLLOWS:-
THE MemberId : N90215260LICDDNRT
Policy No : [protected]
Policy Period : 01/04/2022 to 31/03/2023
Insured Name : A K Gupta
Company Name : The New...
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Address:2 Gotri Vasana Road, Vadodara, Gujarat 390021
Website:www.rakshatpa.com/WebPortal/Login/Anonymous/checkClaim

Dear Team,
I have very worst experience with Raksha TPA. Since more than 10 years I am paying my insurance premium and I never did any claim against my policy.
This year I got injured and hospitalized for surgery. In the hospital cashless facility is not available hence I paid all the hospitalization and surgery charges from pocket and availed reimburshment facility.
I have submitted entire file with proper documentation...
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S
Singhal Rahul
from New Delhi, Delhi
Sep 1, 2022
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Claim not settled after 2 months of claim submission

Cataract treatment claim from my aunt (who is a senior citizen also) was submitted to Raksha TPA Lucknow team in first week of July '22 yet it has not been settled after almost 2 months. The worst part is their response mechanism. Their contact center and mail system are of no use as nobody seems bothered to resolve customer complaints. Escalation mails are not answered back. The contact center executives are so naive with no idea how to...
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S
Singhal Rahul
from New Delhi, Delhi
Sep 1, 2022
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Claim not settled after 2 months of claim submission

Cataract treatment claim from my aunt (who is a senior citizen also) was submitted to Raksha TPA team in first week of July '22 yet it has not been settled after almost 2 months. The worst part is their response mechanism. Their contact center and mail system are of no use as nobody seems bothered to resolve customer complaints. Escalation mails are not answered back. The contact center executives are so naive with no idea how to handle customer...
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G
Genesis: The Creation & The Creator
from New Delhi, Delhi
Sep 1, 2022
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Not responding to claims

Hello sir/madam,
I have not received any update on my previous emails.
I would like to reiterate I HAVE SENT THE DOCUMENTS (Hospital certificate and Pharmacy Bills ALONG WITH Cancelled cheque) to Stellar Sphinx, 4th Floor, Above Himalaya Book World, Road No-1, Punjagutta, , Hyderabad, Telangana 500034

MemberID:-O[protected]MANSPL
Claim No:-[protected]

It was delivered on 16 August....
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S
sumedh1504
from Nashik, Maharashtra
Aug 23, 2022
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My claim amount not credited in bank account till time

Address:Haryana

My claim no [protected] has been passed since 45 days but not any sanction amount credited to my bank account i m tired for that situation so pls credited on urgent basis, not any reply from your side, so pls credited in 1 or 2 days in bank account...
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sumedh1504
from Nashik, Maharashtra
Aug 23, 2022
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My claim amount not credited in my bank account till time

Address:Haryana

My claim no [protected] has been passed since 45 days but not any sanction amount credited to my bank account i m tired for that situation so pls credited on urgent basis, not any reply from your side, so pls credited in 1 or 2 days in bank account...
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sumedh1504
from Nashik, Maharashtra
Aug 23, 2022
Resolved
The complaint is marked as resolved when a company has responded to the complainant, addressed his or her dissatisfaction, and came to an agreement where both parties agreed that the complaint is indeed resolved. However, a complaint can be automatically marked as resolved if a complainant isn't responding or updating a complaint for 30 days after the company has tried to reach the complainant.
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Resolved
The complaint is marked as resolved when a company has responded to the complainant, addressed his or her dissatisfaction, and came to an agreement where both parties agreed that the complaint is indeed resolved. However, a complaint can be automatically marked as resolved if a complainant isn't responding or updating a complaint for 30 days after the company has tried to reach the complainant.

Claim not settled since 40 days

Address:Haryana
Website:www.rakshatpa.com

Dear Sir/Madam, My self Sujit my claim no. [protected] passed since 45 days, but not single rupees credited to my bank account I'm tired for that, pls transfer urgently to my bank account n inform me, I'm very tired for that issue. Thanks, Rahul, [protected]...
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S
sumedh1504
from Nashik, Maharashtra
Aug 23, 2022
Resolved
The complaint is marked as resolved when a company has responded to the complainant, addressed his or her dissatisfaction, and came to an agreement where both parties agreed that the complaint is indeed resolved. However, a complaint can be automatically marked as resolved if a complainant isn't responding or updating a complaint for 30 days after the company has tried to reach the complainant.
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Resolved
The complaint is marked as resolved when a company has responded to the complainant, addressed his or her dissatisfaction, and came to an agreement where both parties agreed that the complaint is indeed resolved. However, a complaint can be automatically marked as resolved if a complainant isn't responding or updating a complaint for 30 days after the company has tried to reach the complainant.

Claim not settled till time

Address:Haryana
Website:www.rakshatpa.com

Dear Sir/Madam, My self Sujit my claim no. [protected] passed since 45 days, but not single rupees credited to my bank account I'm tired for that, pls transfer urgently to my bank account n inform me, I'm very tired for that issue. No any mailing reply from Raksha TPA also.Thanks, Sujit, [protected]...
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A
abjetly
from Delhi, Delhi
Aug 18, 2022
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Delay for settling claim for more than 3 months

Address:F3/20 first floor, sector11, Rohini Delhi 110085

My claim no.[protected]
The said claim was submitted under group insurance policy of BOI on 12.5.2022. The claim is passed long back passed amount
Rs.57319. Even after more than three months the claim is pending for payment.
This is undue delay. My phone [protected].Email [protected]@gmail.com...
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M
Mohit322557
from Panipat Taraf Ansar, Haryana
Aug 15, 2022
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Claim amount not received Query reply for claim 58222122370357

Claim id [protected]
After 8 months still payment not recieved...
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I had submitted claim for Rs 9467 God reimbursement. However an amount of zts 4450 has been paid tome and balance amount has been disallowed. In this connection it is stated
1. Doctor had advised to monitor sugar level regularly in order to watch the sugar level. Advised to purchase glucometer fid the purpose. The cost of glucometer and test stripes have been disallowed. As per insurance Co instant rules the cost of glucomter and test...
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M
mpcl_deepak
from Mumbai, Maharashtra
Aug 8, 2022
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Claiming issue

Address:Micropoint Computers Pvt Ltd, 17/18 Navketan industrial Estate, mahakali caves road, Andheri (E), Mumbai-400093

Dear Sir/Madam,
We submitted the Original Documents to the TPA Office and we received acknowledged copy as well but still they told us submit the Original documents we cant received the OG Copy.

actually we suffering more for my calming processing...

so we requesting you to please try to understand my query because second time Doctor will not provide the documents because its gone 3 to 4 months.
br...
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Revered sir, it has been 3 months we have filed claim, all originals sent to amd raksha ta office, awb [protected], dt 30-5-22, they raised a query for which never got an intimation, on follow up came to know abt same, got an email id frm customer support of aget handling my case vikas.[protected]@rakshatpa.Com, no reply since 2 months 4rm his side, called again cust care rcvd diff email id swati.[protected]@rakshatpa.Com sent her several emails till...
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