Raksha Health Insurance TPA Complaints & Reviews

Address: Anantapur, Andhra Pradesh, 515001

Sir, my employee is number is 337382. Working in punjab national bank. We sent a cashless approval request for maternity hospitalisation of my wife. Name is madam sowmya. We sent request on 2-10-18. Till now, we have not received any reply. More than 50 times i contacted customer care, every time they tell a different story. Some times they are telling they have not yet received mail. Some time they are telling request is received. Every a differnt story. I had never seen this type of customer service and negligence of greivianves. Kindly do needful and approve immediate cashless approval.
Kindly do needful.

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Ghaziabad, Uttar Pradesh, 201001

Website: Raksha Tpa

I have submitted my maternity pre and post hospitalisation claim to rakshatpa on 31.03.2018 and submission was delayed by 6 month due to some complications in health of my infant baby. My original bills and reports was already sent to rakshatpa. But again and again they (Mr kunal) are asking for photostats & scanned copy of bills. They asked reason for delay in submission. I submitted reson for delay duly verified by employer through proper channel i. E. Mail & courier. My claim is still pending despite various follow up and i am not getting any response about it. However i called mr kunal many times for enquiring my claim, but neither he received any call nor replied back. I am helpless, do not know what to do.. Kindly resolve the issue
Thanks
Officer at punjab national bank

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Faridabad, Haryana, 121006

Hi my raksha tpa member of is uic54546879obca and my claim amount of 9801 was approved but my bank account was closed and i gave then the new bank account no with cancelled cheque. I called them and checked that the new account is updated in the system, then they asked for bank statement for old and new account which i also provided but that have not credited the amount to my account. It's been 2 months now and they don't respond to my emails and calls.

Please look into it

Thanks
Naresh kumar mangla

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Raebareli, Uttar Pradesh

Website: [email protected]

Member id uic[protected]pnba and claim no [protected] which is passed at feb 2018 before my account no [protected] which is closed at 31 march 2016 they send neft at this account but rhis account has been closed alredy then t send my account statement and new account no check leaves [protected] then they said that it will be salary account then i send account statement and salary account no check leaves [protected] but i did not found my claim till now

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Mansa, Punjab, 151501

Website: [email protected]/[email protected]/[email protected]

Dear sir/madam,

In above reference my name is mukesh bansal i am employee of obc bank my pf no. Is 339296 i am regular claim medical bill for reimbursement of my father who fully dependend on me but my last bill delay for final payment and his claim no. Is [protected] however this claim is registered 10 july for raksha tpa chandigarh and passed as on date 23/07/2018 for final payment of rs. 23033/- but now till dated my amount did not credit in my bank account as per your record and i make many call for my payments but any time give me simple answers of my question sir your payment settled in your within week but last 2 or 3 week same status. I humble request you pls settled my payment as soon as possible without any delay.

Regards

Name mukesh bank
Pf no.339296
Mob no. [protected]
Alternate no. [protected]
Obc bank

View replies

N

Nitin Jadhav Proclaim

from Savantvadi, Maharashtra

Oct 16, 2018

With the reference claim No [protected] Mrs. kalyani Baisane-Jadhav.
Till date claim was not setteled neither update in online portal i checked it by everyday, request you to settel my claim at earliest. As i send all claim documents to you. Please update current status of claim.

Thanks and Regards
Nitin Jadhav
[protected]

Reply

C

CA Ashish Agarwal

from Makrana, Rajasthan

Oct 22, 2018

I applied for insurance claim at the time of discharge on 13.10.2018 but claim not approved up to 14.10.2018
Raksha Tpa is very bad plz not take mediclaim in which raksha Tpa involved

Reply

Helpful

Found this helpful?

2 Comments

Post your Comment

Comment Guidelines

Address: Dehradun, Uttarakhand, 248001

I forwarded my file to my cmo meerut on 24.4.2017 and the concerned person (Mr abhishek verma) who collected my file from my cmo meerut on 01.05.2017 and there is no response from their side.
This is a request to please look into the matter and do the needful at the earliest.
Hoping to get a positive response on this matter.
Regards
Manju joshi
Membership id-uic[protected]obca

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Chennai, Tamil Nadu, +91

Dear sir/madam,
My claim number [protected],
Member id UIC54526742SBI,
Patient name Lingammal S.
Claim bills received on 17/07/2018.
I am working as Unit Manager at SBI Life insurance for 3 years. At 23/06/2018 God blessed me girl baby in ANDAL Hospital at Rajapalayam, Virudhunagar Dt. That is non network hospital so that I had applied for reimbursement along with requested all medical bills. In hospital they don't have computer speciality so that instead of printed final bill, doctor give me hand written bills. But Still I am waiting, claim not settled. Kindly do the needful. Thank you.

Thanks
Subburaj S
Mobile [protected]

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Recently i had undergone heart surgery in bangalore. The total cost of the surgery was rs 2.50 lakhs at panecea hospital. My main insurer star health cleared rs 2 lakhs immediately. But my corporate insurer raksha tpa is dilly dallying to clear the balance amount of rs 50, 000 for the last 3 month. Even i submitted noc from star health. Till date, after a gap of 3 months i have not received any feedback nor my claim amount. I have submitted all the documents, original/zerox copies i got from hospital and star health repeatedly as and when they asked for it.

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Member id: uic54542701obca claim no. [protected]

Dear sir,

I have submitted a mediclaim bill of rs.8224/- on dated[protected] along with original bills and a cancelled cheque of my staff salary account no. [protected] (Due to close of staff od account no. [protected], which was previously linked as bank detail with insurance co).

On perusal for settlement of claim your officials, it was informed me that claim has been passed at their end and sent to insurance company. They have also told me to send request letter along with a cancelled cheque and statement of both accounts for change in reimbursement account, which were also sent on dated[protected]. Further i again called several times at your jaipur office and it was informed that neft dated[protected] has been returned. Statement of my both the accounts from[protected] to[protected] are also sent.

I have called on[protected] several times and sent mail [protected]@rakshatpa.com, faridabad. [protected]@rakshatpa.com & [protected]@rakshatpa.com but till date i have not received claimed amount.

I request you to takeup necessary action for reimbursement of amount.

Regards
Mahendra kumar singhvi
Member id: uic54542701obca

Helpful

1 other people found this review helpful

1 found this helpful

Write a comment

Post your Comment

Comment Guidelines

Address: 400063

Website: www.rakshatpa.com

Respected sir

This was the mail dated 23062018 by shri prasad wallkar

With references to below email would like to inform you that on scrutiny of claim documents charges related with dm and its complication paid in this claim and charge related with eye ailment will not be admissible hence deducted rs 4000 and rs 1000 total rs 5000

Please look in to the matter the treatment which i have done is one of the complication of diabetes called glaucoma this complication is caused to diabetes patient and i have processed this claim under 13 diabetes and its complication as glaucoma is one of the complication caused to diabetes patient so pass the deducted amount of rs 4000 otc review dated 09032018 and rs 1000 as follow up charge dated 26032018 total rs 5000 so pass this less amount as soon as possible and reply to us

The above messages is not accepting at your website email to customer care kindly guide us accordingly.

Please revert this mail to grievance message.

Yours faithfully

Kishor m hedau
Mumbai
[protected] [protected]

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Dehradun, Uttarakhand, 248005

Member id : uic54563381pnba
Name : rajendra singh rawat
Claim no. [protected]

Kindly tell the reason of non payment of this claim since 14 june 2017. Even after 1 year of submission of claim it is not reimbursed till now. My father is not well so he is not able to regularly contact the tpa.. Also intimate any document you need to pass the bill and speed up the process of reimbursement.

+1 photos

View replies

G

G Madhava Rao

from Bengaluru, Karnataka

May 27, 2019

A report published in The New Indian Express, dtd 25.5.2019 about this insurance company''s unethical attitude is attached for the general public.

corporate claim not settled - Comment #3443128 - Image #0

Reply

Helpful

Found this helpful?

1 Comment

Post your Comment

Comment Guidelines

Address: Udham Singh Nagar, Uttarakhand, 244713

Website: [email protected]

आपके द्वारा 21000 का पेमेंट नही किया गया जो कि गलत है में मानता हूं कि प्राइवेट रूम लेने से 20%एक्स्ट्रा चार्ज लगते है तो आपको 20% काटकर ही पे करना चाइए था मुझे केवल रूम के बारे में बताया गया कि इसके आपको एक्स्ट्रा पे करने पड़ेंगे। मेरे द्वारा आपको सेल्फ से 21000 के पेमेंट के लिए भेजा जाएगा और में उम्मीद करता हूँ कि आप निराश नही करेंगे। अगर ऐसा हुआ तो यकीन कीजिये न ही कभी आपकी पालिसी लूंगा और आपकी सर्विस की पोस्ट वायरल करके सबको सचेत करूँगा। लेकिन मुझे उम्मीद है ऐसी नौबत नही आएगी।
नितिन अग्रवाल
पुत्र श्रीमती सुमन अग्रवाल
काशीपुर

Jun 03, 2018

Updated by nitin 1 Member id UIC[protected]

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Ludhiana, Punjab, 141013

Website: www.orientalinsurance.com & www.rakshatpa.com

Member id : o[protected]
Policy no : 233902/48/2017/7108
Insured name : smt. Sukhbir kaur
Claim in respect of : smt. Sukhbi r kaur
Relation : self
Claim ref no : [protected]
Employee number : na
Corporate name : individual
Entity name : the oriental insurance co. Ltd.

The claim is pending from last one year as they have not settled the claim
They don't even have time to revert to my emails

Thanks
Harinder preet singh
S/o s. Sukhbir kaur
#[protected]
Email :- [protected]@gmail.com

May 31, 2018

Updated by 7009820064 The claim was processed in July, 2016
Even mailed to your their H.O and R.O, Nobody is reverting

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Amritsar, Punjab, 143001

Website: www.rakshatpa.com

As per telephonic conversation on[protected] on 11 may i was told told claim has been passed and claim amount 2 lakhs would be credited to bank account on friday.
To my utter shock today morning my claim status showed rejected as per clause 4.1 and 4.2
I want to bring to your notice that rejection on basis of clause 4.1 and 4.2 is invalid.
As per clause 4.1 any disease which is preexisting is excluded from insurance. We have repeatedly brought to your notice that mr rajesh kumar was not suffering from any ailment before suffering from heart attack. We have already submitted the required document and declaration stating that there were no preexisting ailment.
Also as per number two in reason of non payable it is stated that is k/c/o dm. We want to highlight the mr rajesh kumar is not diabetic. Neither he was suffering before heart disease nor is he suffering now.
Also clause 4.2 there is a list of diseases which are not payable if manifested during currency of policy want to highlight heart surgery is not included in this list.
We got insurance from your company considering its brand value however it is setback for me to see such level o[censored]nprofessionalism from your end. We are not at all convinced with the rejection reason that are conveyed to us. It humble request to reconsider the decision since i am writing this on facts and documents already submitted from our end.

May 20, 2018

Updated by Indu Kesar The matter had been pending for long since 6th Nov 2017.
As per telephonic conversation on[protected] on 11 May I was told claim has been passed and claim amount 2 lakhs would be credited to bank account on 11 May 2018 (Friday).
To my utter shock on 15 May 2018 my claim status showed rejected as per clause 4.1 and 4.2
I want to bring to your notice that rejection on basis of clause 4.1 and 4.2 is invalid.
As per clause 4.1 any disease which is preexisting is excluded from insurance. We have repeatedly brought to your notice that Mr. Rajesh Kumar was not suffering from any ailment before suffering from heart attack. We have already submitted the required document and declaration stating that there were no preexisting ailment.
Also as per number two in reason of non-payable it is stated that is k/c/o DM. We want to highlight the Mr. Rajesh Kumar is not diabetic. Neither he was suffering before heart disease nor is he suffering now.
Also clause 4.2 there is a list of diseases which are not payable if manifested during currency of policy want to highlight heart surgery is not included in this list.
We got insurance from your company considering its brand value however it is setback for me to see such level o[censored]nprofessionalism from your end. We are not at all convinced with the rejection reason that are conveyed to us. It humble request to reconsider the decision since I am writing this on facts and documents already submitted from our end.
Kindly help in resolving the issue

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Website: www.rakshatpa.com

Raksha TPA – Non responsive customer care

Sadly (by bad luck) our TPA for Insurance is Raksha TPA. They have several numbers as their customer care numbers Faridabad[protected]-180-1444, Mumbai[protected]-220-456, Bangalore[protected]-425-8910

Unfortunately not a single one works. The numbers do connect but all they say is no agents are free now, please call after sometime.

We are unable to contact Raksha TPA for our queries related for insurance claim. We are trying since last 3 days.

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Faridabad, Haryana

Website: rakshatpa.com

In respect to the claim number [protected], original investigation reports, originai brain plain, original mri ls spine plain, original mri screening with film dated 03/10/2017 have already been sent to you via dtdc docket number z52268862 which was received in your office on 16/01/2018 (Copy of docket and receiving is attached in the mail).

It seems that the docket received at your office is not updated in the computer records.

Please check my claim file if the reports and mri's are already attached to it. If so, please proceed further to approve my claim.

Everything required to process the claim is already provided by me.

Until today, no information is given to me about the status of the claim. Also i have sent you lot of mails but there was no response/communication from your side to proceed further in the matter.

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Gautam Buddh Nagar, Uttar Pradesh, 91

Website: www.rakshatpa.com

My wife neelam rao was hospitalized on dated 03/01/2018 for maternity. She was admitted in apollo hospital noida and next day on 04/01/2018 she gave a birth a daughter, on another day she discharged from hospital. I applied a claim amount of neelam rao18100/-and baby of neelam rao 34885/ on dated 16/01/2018 to raksha tpa gorgon. My memberid no is n90240264licmrt and my claim number is [protected],[protected]. They already settle claim no.[protected] but another claim put some queries like. Original pre-numbered, preprinted duly signed and stamped receipt against final bill of the hospital but i have already send my all original hospital bills as on date 16/01/2018 via speed post (Eu[protected]in).

+1 photos

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Patna, Bihar, 800001

Website: www.rakshatpa.com

Sir,

I have sent claim form along with original medical bills of my mother smt malti devi to raksha tpa boring road patna on dt[protected] having claim amount rs. 22593.76 but till date claim has not been registered on the site. The said claim has kept under the table drawer. Despite several reminder sent via email and talked over the phone with mr. Hiren, claim is still pending for registration. I also said over the phone to office of rakshatpa that if there is any problem in settlement of the claim so please return the original bills to me along with mentioning proper reason for withholding the claim since last 4 months then return. But, matter is still pending. Service of the raksha tpa is very poor. They always delay in registration of claim and settlement. Earlier, a bill of rs. 2630.00 has been passed by raksha tpa in 8 months. I am so much fed up with such services. Please look into the matter.

Member id: uic[protected]obca
Policy no. [protected]p[protected]

+1 photos

Mar 14, 2018

Updated by 348082 Sir,
Complaint has not been resolved yet. Please look into the matter

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Hisar, Haryana, 125001

I am completely not satisfied with your service as my mother is being diagnosed with retro peritoneal tumour in aadhar hospital hisar. The tpa agent refused for cashless service and says it can only be claimed later since amount sanctioned for this disease as per the company is 25 to 30 thousand while the cost of operation as per the doctor is 1.5 lacs. I am still getting my mother treated here and paying all in cash. What was the benefit of this cashless raksha tpa card then when i had already informed the tpa faculty in the hospital about the operation to be taken place the next day!

Helpful

Found this helpful?

Write a comment

Post your Comment

Comment Guidelines

Address: Kottayam, Kerala, 686013

I am bijo john
Member id :m[protected]jgl
This cimplaint is regarding deduction of my claim amount.
First i confirm the tpa customer care about my room rent and my sum insured amount. I got the information is room rent is 2% of my insured amount (150000) that is 3000rs per day. Igot 1500 per day rent room. And now it is deducted at the time of claim approval. They deducted and calculated it to 1 % amount. And they mentioned the approval letter some non medical deductions like nursing care, icu care, ot procedures etc..in hospital senario i dont think it is not a part of medical care. Everybody know that after surgey nobody can survive without icu care and nursing care. It is very harrazing situation to the consumer. My discharge from hospital is delaying one day because of this arguments to tpa person. So kindly do the needful as soon as possible.

Raksha Health Insurance TPA Complaints & Reviews

File a complaint to Raksha Health Insurance TPA

Raksha Health Insurance TPA reviews & complaints page 9

maternity hospitalisation cashless approval

Post your Comment

uic545324835pnba non settlement of my claim submitted on 31/03/2018 to rakshatpa pvt ltd

Post your Comment

claim amount not received

Post your Comment

not found my claim amount 22907 rupees

Post your Comment

final payment did not settle against my claim no.

Post your Comment

maternity claim

Post your Comment

still 50 days, claim not settled

Post your Comment

delay in processing

Post your Comment

claim passed but amount not credited in account

Post your Comment

less amount pass for claim no 54521819007860 and policy no. 5001002817p110689453

Post your Comment

corporate claim not settled

Post your Comment

service

Post your Comment

delay in claim

Post your Comment

rejection of claim number 556221718279944

Post your Comment

raksha tpa non responsive customer care

Post your Comment

issue related to my claim amount

Post your Comment

claim in query

Post your Comment

claim status not received since last 4 months

Post your Comment

refusal for cashless facility

Post your Comment

not issuing the required amount.

Post your Comment

Related businesses