Raksha Health Insurance TPA Complaints & Reviews

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

Claim id [protected]
After 8 months still payment not recieved

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 stripes (an important item)these items are admissible as may be seen from Annexure II attached TO NABARD circular of OPD facilities
Further an additional amount of Rs 2100 has also not been paid. This amount represents spectacles and lens charges. These items are also reimbursable under NABARD instructions. It is requested that the case may Pl be seen in the light of instant guidelines and rules and reimbursement may be paid in full

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.

After the following they told us submit the Original Documents but sir how it is possible to submit again the OG copy.

Please find the acknowledge copy of my submitted OG documents.
requesting you to please help of this case. its my humble request.

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 date no reply... Rcvd email reg cancellation of claim due to no reply again sent email to above both 20 days ago dinesh.[protected]@rakshatpa.Com. No reply till date from any one of them. Can somebody explain what is going on please and reply me back on [protected]@msn.Com. Thanks and regards

I am trying to connect the customer care of Raksha Health TPA from last few days but unfotunately the has been connected every time pls do the needful.

I have submitted the claim on 13th July with all required documents along with hospital registration at Faridabad location but they are asking the same again n again.

No one pick the call at customer care
No call Back
And Finally got the call back after 6 days but executive disconnected the call before telling the member id

I am fed up with the service.

Regards
Jatin Mittal
[protected]

Proposed tech term plan online and LIC digital sales team assigned to RAKSHA TPA Hyderabad to conduct medical tests and attended for medical tests on 29th June 2022 and today is 20th July 2022 and still not uploaded all the reports properly and even though diagnostic center is ready with reports on 29th June 2022. Still asking 1 or 2 days time to upload.

Dear Sir/Madam,

This is reference to a letter of deficiency letter received from Raksha TPA with regard to my claim ref. no. [protected], where I am pained to inform you that all the relevant documents had been dispatched to your office twice and till date I have not received the reimbursement. The claim was first documented in Dec 2021. Receipt to deficiency letter, I dispatched all the documents for second time where dispatch courier holds the below mentioned

Documents List ( Dispatched ):
1. Application
2. Bill summary
3. Complete Bill with letter of material used for PEG during hospitalization and treatment of cancer

All the above furnished documents were signed and stamped by the Hospital RGCIRC, Rohini and sent to you as Original

Hence, post submission of above mentioned documents it pains to receive the reminder for deficiency

Henceforth, request you to Immediately process my claim without raising any further demands for submission, as it is very difficult to contact Hospital in this COVID scenario where me and my Husband are suffering from severe health problems

I would really appreciate your kind support in processing my claim

I have claimed last year but there's no response from raksha TPA

Ref:
Raksha Health Insurance TPA Complaint Status Update [ID: 3220849]

I have to inform you that the baby was born on date 20.04.2022 and the name of the baby has been added in HRMS dated 26.04.2022. The pdf attachment has been added along with the mail with date and timing of adding the dependent "baby of Shambhavi Singh" as a proof to the Raksha TPA. The raksha tpa app also reflecting the dependent details after adding in the HRMS.Hence You are requested to initiate the claim settlement process of My dependent as earliest to resolve my issue as you have already taken more than 66 days to clarify this. And also kindly update the status of the claim no.[[protected]] in Raksha TPA App . The worst experience I have found this time with your service .You should clear out my pendency as earliest still no fruitful response or resolution has been done from your side yet. You are requested to resolve my issue or i have to move for complaint portal for this worst experience.

The issue still has not been resolved. Please took this matter on priority and register a complaint regarding this or make it clear on how many more days required to settle this claim as it still more than 66 days has been passed to settle this claim . My mobile no is [protected].

I Zahid Ahmed Policy No[protected] of National Insurance. I lodge a Claim in Sept 2021 of my wife Delivery of Baby under Raksha TPA. Claim No of Raksha TPA is [protected]. All the Original Documents related to Caesarean of Wife and Original Bills are sent to Raksha TPA Office. So many time i want to call on Toll free no but there is no response from toll free number. I am also touched with Raksh TPA via mail and thet reply me your claim is under process Now Raksha TPA sent me mail for rejection of Claim.
Sir they are Harassed me from last Eight Month. So plz help me for Payment of my Claim.

Claim no CLAIM no [protected] Leela chandaliya

I have to inform you that the baby was born on date 20.04.2022 and the name of the baby has been added in HRMS dated 26.04.2022. The pdf attachment has been added along with the mail with date and timing of adding the dependent "baby of Shambhavi Singh" as a proof to the Raksha TPA. The raksha tpa app also reflecting the dependent details after adding in the HRMS.Hence You are requested to initiate the claim settlement process of My dependent as earliest to resolve my issue as you have already taken more than 56 days to clarify this. And also kindly update the status of the claim no.[protected] in Raksha TPA App . The worst experience I have found this time with your service .You should clear out my pendency as earliest still no fruitful response or resolution has been done from your side yet. You are requested to resolve my issue or i have to move for complaint portal for this worst experience.

Sir/Madam,
With reference to your trailing mail, I have to inform you that the baby was born on date 20.04.2022 and the name of the baby has been added in HRMS dated 26.04.2022. The screenshot has also been added in this mail and also the pdf attachment has been added along with this mail with date and timing of adding the dependent "baby of Shambhavi Singh" as a proof. The raksha tpa app also reflecting the dependent details after adding in the HRMS.Hence You are requested to initiate the claim settlement process of My dependent as earliest to resolve my issue as you have already taken more than 56 days to clarify this. And also kindly update the status of the claim no.[protected] in Raksha TPA App . The worst experience I have found this time with your service .You should clear out my pendency as earliest still no fruitful response or resolution has been done from your side yet.

One year completed but claim is not registered and not settled

I lodge claim on raksha tpa website dated[protected] and i has been sent all original document via courier. But company not settled my claim yet to now. i tried many phone calls and mail but not body respone. when i checked online in website where show only query pending but not mention which query pending.

NAME - DHARAM PAL
POLICY MEMBER ID - M58344034SHGB
CLAIM NO - [protected]
MOB - [protected]

Sir I had sent my claim and it is passed before one month. My claim had already sent to payment section one month ago. But still claim amount not credited to my account.
No body entertain my mail
My ID is M58171772BOI, .

We had sent a claim of Rs. 4600/- on march 2022 through speed post. my member id is M58175257BOI. after passing of almost 3 months claim is still yet to settled. they not pick call or rplied in mail once after mailed many times that your claim is under process.
very poor service. may i know when my claim will be settled or will get rejection letter.

Dear Sir/ Madam,

Greetings to you!

My son K.Kamaltejasvi got an injury & admitted in Thirumalai Mission Hospital, Ranipet. on 13.04 2022
after the surgery he was discharged on 15.04.2022. member Id is O[protected] & intimation number is
[protected]. The claim details are enclosed as per your requirements. After submitting the bills
on the name of query & insufficient documents every week you have been asking & I was submitting. This
is really more painful than the injury. The hospital had given justification for not able to produce
the Original Pre-numbered, Preprinted duly signed and stamped receipt against final bill of the
Hospital THIRUMALAI MISSION HOSPITAL for Rs. 25818 /- & Which is not able produce by hospital.

Then you are unnecessary raising the query on this. On the name of medical insurance you people are
really cheating the customer, making trouble & its really painful.You have been delaying the claim about
one month its not justified. We have insured & right to claim the same. I will not accept for any
deduction from this claim. If you have any doubt, clarification on the bills, please clarify with the
hospital but I can't loose any paid amount.

We are really unhappy with your TPA services & address the issues and bitter experiences with Oriental
insurance for choosing your TPA.

Please try to solve my problem, If not I am ready to go for a consumer court get it solved.

With best wishes,

Kumar