Raksha Tpa Pvt Ltd — pre and post hospitalization claim rejection

Address:

New Delhi, Delhi

I have lodged claim of pre and post hospitilazation under member i'd: pnba under policy nos:
1. [protected] of rs 10570/- and
2. [protected] of rs 8969/-
Both calim are rejected /not by raksha tpa pvt ltd without any intimation.
My wife delivered baby with complications, doctor mentioned delivery date 20 jan but she delivered on 11 jan due to complications. And due to which delivery is cesearian.
Now they denied claim amount saying not payable. As it is clearly mention in irdai cir no: irda/hlt/reg/cir/146/07/2016 dated 29.07.2016 that for pre hospitilzation it is 30 days and for post it is 60 days.
I have submitted all the original documents to them and also discharge copy of hospital. From 11 jan to 14 jan my wife admitted to hospital which already covered under cashless (Again proof submitted).
But they straightly denied my pre and post hospitilazation claim saying it is not covered under my policy. Toatal amount due is rs 10570 + 8968 = rs 11539/-
This is harrassment of customer and due to wrongful rejection of claim of the expense of hospitalization, i have suffered a lot & also received great mental agony, harassment and the attitude of insurance company seems to be deficient, negligent and careless one.
It is clearly mentioned in the irda circular. The people of raksha tpa are unprofessional they even not contacted me over phone or mail before rejection.
Irdai is controlling authority of insurance in india. I don't whether they are compling irdai guidelines for insurance.
I hope, in consumer complaint site i will definite get justice & it will be a great example for insurance companies, who cheating customers.
Waiting for your early positive response.

Thank you