TTK Healthcare Complaints & Reviews

sir
I have claimed the hospitalization expenses of my wife having the ID of BLR-NI-B[protected] B by name B. Kirithiga for an amount of Rs,21,662.00 via claim no BLR-110-CL-0000400. is kept pending till date .
With so many reminders I have not not received any fruitful action. Please do the needful.
With regards
N,Baladhandayutaham

Rejection of Mediclaim

This is in reference to myMrs Sujatha.H.K., I had excessive bleeding and was un managable i was adviced to get abdomial myomectomy by Dr.Anumpama who further reffered me to Dr Nanadini Devi [ Indra Clinic 7th Main, 9th Cross malleshwaram, Bangalore -03] submitted the documents thogh my office it was rejected [ ttk] the case stating it is a case infertility.

I have been advised to try IVF as my falopian tubes were patent but due un managable excessive bleeding i had to under go the surgery immediately.

I further produced the letter from Dr Nandini Devi clarifying this on 19/10/10. But they rejected stating the same reason.

According to TTK healthcare conditions “ Hysterectomy for Menorrhagia or Fibromyoma “ is not included under insurance and surgery I underwent was abdominal myomectomy and hysterectomy.

Please advice how to take this matter legally.

Name Patient : Sujatha.H.K.
Mrs Sujatha.H.K.
TTK Card No -BLR-NI-Y[protected]A

Detail information of given two claim and delay of passing such a claim........

CASE FOR : DARSHITABEN, TTK ID : AHD-NC[protected]B

(1) CLAIM NO : AHD-0210-AM-0000001 AND SETTLEMENT NO : AHD-0210-AR[protected], IN THIS CLAIM 15,043/= AMOUNT IS REJECTED DUE TO SI EXHAUSTED, BUT ACTUALLY BALANCE SUM INSURED IS 15157/= IN ACCOUNT.

POLICY NO IS : 301100/48/08/[protected]

(2) CLAIM NO : AHD-0210-CL-0000020 AND SETTLEMENT NO : AHD-0310-CR[protected], IN THIS CLAIM 8,540/= AMOUNT IS REJECTED DUE TO NOT PROVIDING ORIGINAL DOCUMENT, BUT I SUBMIT REQUIRED ALL ORIGINAL DOCUMENT ON[protected], BUT NO PROCESS TILL TO DAY. Balance Sum Insured (Rs.): 109881 AT PRESENT.

POLICY NO IS : 301100/48/09/[protected]

I am an employee of HealthAsyst Bangalore(1356). Few month backs (2months), i faced some nasal problems , for which i had consulted Manipal
hospital for a check up as it was closer to my office. After undergoing few diagnostic tests , they have identified it as "B/L Sinonasal Polyposis With Pan Sinus".


My Dr Girish Rai recommended to resolve this problem through a surgery called Endoscopic Fronte ethmoidectateral Surgery (surgical removal ) and suggested to do the operation at the earliest. .

Based on this, I had send a pre-authorization request through Manipal Hospital after consultation with the ENT Department for getting Insurance Approval on 19-Jun-2010 from TTK. As I received the approval on 20-June-2010 for Rs.20000 from TTK through SMS and the hospital received the same via fax. Hence I decided to get the further treatment at Manipal itself, else I was planning to get the surgery done in my native.

Based on these, I got myself admitted for surgery on 24-Jun-2010 and i availed myself the cashless facility.

The surgery happened on 25-June-2010 and when i was about to be discharged from the hospital on the next day, i was told to pay-up Rs.32,517 from my pocket as TTK had withdrawn the earlier approval they had sent which put me off both mentally and financially.

The reason for denial as per TTK was due to a 2 year exclusion as per policy terms and conditions and hence cashless access was denied.

I would like to know why a sum was approved without checking the policy terms and conditions, there negligence is making me suffer financially, else I would have planned it in a better way. .If I had been properly intimated about this i would have opted for a surgery in my native place at the fraction of cost, that too at a later date . I suspect a foul play and feel cheated and robbed by two institutions.

Because of all this I had to avail a lone which has to be repaid now. Kindly look into this and get the back to me .

I have submitted claim of my son ( claim no. CHE-0510CL0004994 and short falll/querries were also replied in june 2010 . The reply to querry was sent through speed post no EH[protected]IN and I have the receipt that It has been received at T. Nagar on 21.06.10 .

When I contacted customer care I was told that it was not received but after few weeks when again contacted they confirmed that it has been received and cleared on 30.8.10. and was assured that the payment will be made within 7 days or so.

Today when I contactec after 10 days I have been informed that the reply is not received for querry.

What do I do .
I have sent all the apers thrice by courier and thrice by e. mail but all vain.

Could any one guide me how to proceed further?

rakesh kumar khandelwal
policy no.[protected]
TTK ID

My mediclaim policy is with united India insurence company gulbarga karnataka.And TPA is TTK bangalore. My mediclaim policy no. is 240600/48/09/97/00000878. untilnow i have not received Photo ID card from TTK Bangalore.I would like know how this nuesence will continue from ttk bangalore.
Satyanarayan joshi
cell. No.[protected]
email: [protected]@rediffmail.com
Address.
Satyanarayan joshi
H.No. STRT 14/1 Alstom Township
Shahabad-585229 Gulbarga Karnataka

Ref : CHE-EI-T[protected]B


Incorrect Name Correct Name

GAFFOOR A GAFFOOR G A




Please correct the name as sought above and send the fresh card.

MY NAME IS UNNIKRISHNAN NAIR, POSSESSING "SBT-NRI HEALTH CARE" INSURANCE THROUGH UNITED INDIA INSURANCE COMPANY. THEY HAVE APPOINTED "TTK HEALTH CARE TPA PVT. LTD." AS THEIR THIRD PARTY AGENCY TO ASSESS AND SETTLE THE CLAIMS.

MYSELF AND MY FAMILY IS PROVIDED WITH THEIR CARD NOS.: KOC-UI-S[protected] A TO D BY "TTK HEALTHCARE".

THE POLICY WAS ISSUED AND VALID FROM OCTOBER - 2009 AND SUBSEQUENTLY MY WIFE GOT ADMITTED IN THE HOSPITAL FOR "THYROID" COMPLAINT. THE DOCTOR ADVISED HER TO UNDERGO AN OPERATIVE TREATMENT AND OPERATION WERE CARRIED OUT ON MARCH - 2009.

UPON SUBMITTING OUR CLAIM, TTK HEALTH CARE HAS REJECTED OUR CLAIM STATING THAT "PRE-EXISTING" DISEASE. BUT IN THE ISSUED POLICY THIS DISEASE IS NOT SHOWN IN THE "EXCLUDED" CLAUSE AND BESIDES, THERE IS NO EVIDENCE WITH THEM THAT IT EXISTED WHILE APPLYING FOR THE POLICY.

I HAVE SENT MANY LETTERS AND TELEPHONE CALLS BUT WERE NOT ATTNEDED OR NOT REPLIED SO FAR. NOW A DAYS NOBODY IS ANSWERING OUR CALL AS WELL.

THEREAFTER, WE HAVE APPROACHED "UNITED INDIA INSURANCE COMPANY" THE POLICY ISSUER AND ITS GRIEVANCE CELL BUT WITH OUT ANY RESPONSE.

I REQUEST YOU TO PLEASE HELP US OR ADVISE US HOW TO GET OUR CLAIM FOR AN AMOUNT OF RS.23,429/-.

BESIDES, IS IT POSSIVE TO APPROACH "INSURANCE OMBUDSMAN" FOR GETTING THIS CLAIM.

AWAITING FOR YOUR VALUABLE RESPONSE.

REGARDS,

UNNI.K.NAIR
MOB.:[protected]R)

Dearsir,

sir my name pandu i am working as a relationship manager indiainfoline ltd , last year in my account hdfc bank salary account dedected 1000 Rs , purpouse of ttk health card i resign date of 31/11/2009 ,till date i did not receive any card , sir my mother some health problems last 4 moths my money was gone around 19000 some testing medicines sir kindly refund this amount

I have a policy with ICICI lombard life insurance and the TPA is TTK healthcare services.
The policy details are
Policy Number: 4034/fpp/04191271
card number : IHPN[protected]/01.

Claim reference number : L849669

I have claimed for reimbursement on 11-Dec-2009 month. As per the policy they are supposed to clear it in withing 10 working days. Now it is almost 4 months over, still there is no response from them.
Every time when I make a call to customer service help desk, I am hearing the same words that "It is in process". This is happening since three month. Due to this I am loosing the interest on my money since almost 4 month.

Please help me on this regards and make them to settle my amount as early as possible.

Thanks & Regards
Venkat

claim against policy No. 4034/FPS/02842401/00/000
i had claimed for my hospital and head injury on 18-oct-2009 against my brother Tabish Ali Khan
policy no 4034/FPS/02842401/00/000 . The policy was taken from ICICI
LOMBARD health insurance and TTK HEALTHCARE TPA PVT LTD. TTK had raised a shortfall on 15 feb 2010 it was.

1- original medical bills
2- proper Discharge Card
3- Medical Certificate by Treating Doctor
4- indoor case paper photocopy.

which was fulfilled by me & i have send them scan copy as well as hard
copy and they have received courier on 8th march 10 .
after that TTK raised another shortfall on 09-jan-2009 which again was
fulfilled by me. eventhn till date we have not received any call from
the company and i have been continuesly calling them asked to know
about my claim status but there is no proper response from the company
side. I have also send the same to IRDA to take
action against these company but got no response.
the claim amount was of indian Rupees 16060.00.
the amount was spent by my hard earned income and today i am in dire
need of this fund. Now coz of all this i am physically, & mantly
stressed & my health is getting down.

Tell me what i should do?

S.B. MARIADASS
RESERVE BANK OF INDIA (Retd.)
TTK POLICY No. CHE-UI-R[protected]
MAF NO. R173

We are deeply offended on the services provided by TTK HEALTHCARE SERVICES PVT.LTD.
My dad is undergoing treatment for CA lung, the hospital Sri ramakrishna at Coimbatore has stopped services with TTK as they have failed to renew their tie-up. Earlier the list of hospitals had this hospital name but no more services are entertyained by hospital because of the poor services rendered by TTK, (although the name of the hospital is still there in the list).

Now because we started the treatment ion the hospital we still continue to get treated and our claims are going as re - imbursement, the sad thing is that our re - imbursement takes a very long time and none of the officers take the responsibility of answering us during the process. They need us to call them everyday at least twice and yet they do not answer their only reply to me was, leave your no. and we will call, but in vain. The latest was this reply.

Muniraj.Y/AM/Bangalore/TTKH TPA" to me
show details Apr 8 (4 days ago)

Dear Parveen

As all the process is happing in chennai beanch itself from our end we have send all the documents which you had handed over to us .hence forth pls make the followup's with chennai branch. you can interact with Ms.vidhya- contact person.

Regards
Raj
----- Original
After our policies being insured as corporate ( RBI Bangalore), please see this reply and answer dear senior officers.

Why dont we have any senior officers Nos. like the GM/ BM Nos.? like all the other insurance companies, I must say that once I had faced problems even with the TPA Medi Assist, but because the GM number was on the net I had her contacted and she solved the issue in less than 24hrs. HATs OFF.

The call centers reply too at TTK([protected]) was attrocious, like we do not have power/ systems down and what not.

Now I request you to kindly settle my bills pending since Nov. 2009.

Thanks,

Praveen,
[protected].

TTK Health Care Chennai - Always in search of some excuse to hang the medical insurance claims for people. I am a corporate employee and my father was admitted for the severe Kidney disorder, in which 90% of his kidney is not working. I submitted a big bundle of all the papers, reports, bills, discharge summary, prescriptions etc to them. Firstly, the extra qualified doctors of TTK says my father whose cretinine level is 5+ and is suggested to go for dialysis by various hospitals in Delhi is normal. Then they say to claim it we require 2years past history reports, to find the root cause analysis of the problem.
It is quite surprising that to reimburse the current bills they require 2years old paper!
Can anyone please guide me how to complaint against such a company who claims to help people at their weakest points that is medical and actually shows back when we need them!

sir
CLAIM NO CHE-1009-CL-0005497
i submitted my claim on 26.10.09 and on 4.11.09 ,MRI scan report was sent based on there letter.Subsequently i made several phone calls about the status of my claim,and no proper reply emerged from them.i even went to there office at T.nagar,but i was not allowed to see the higherups.I even sent a reminder on 23.12.09,informing that in the event of further delay,i may go to consumer court.even for this i have not received any reply.My claim no-CHE-1009-CL-0005497..Even though i have been holding the policy for the las 9 years,i am very much upset with the way,TTK HEALTH CARE is handling.Also,i find there is no proper mecanism exist in TTK,to settle or otherwise within the stipulate time.Can i go to consumer court for this issue?
ramadoss

Dear All,
I am working with India infoline group and we have a medical group insurance done through TTK Health Services. My wife was hospitalised and i had send the claim form and all relevant documents(including teh pending and query documents) to TTK office in the first week of September. I have been reguraly calling([protected]) and following up with them on the status and every time i get a reply that the documents are with the team of experts and pending for a final check and that they would get back to me in a couple of days. I must have called them atleast 50 times in the last 3 mths and i keep getting the same status. Request you to kindly look into the matter and help me in getting my claim at the earliest
Haroon Ali Merchant
Employer:India Infoline
employee no: C64176
Policy No. MUM-NC-M[protected]A

Respected Sir,
I would like to have your views on my case:-
My son is working for a corporate house in Mumbai. He has the medical insurance cover under TTK health care for himself and me 63 and my wife 56. I wanted to go in for a cataract eye operation. We approached Venu eye hospital and were given to understand
that they dont have tie up with TTK. Immediately we rang up the helpline of TTK who assured us that we can operate in Vinayak Hospital and the card limit was 1 lakh and we could get cataract operation done there.
We gave the papers to Vinayak hospital and the doctor had given estimate for the operation Rs. 25000. The same was faxed to them and in reply was

Authorisation- Approved dt 10/11/09
Authorised- 15000(Fifteen Thousand only)
Remarks Send full bill and discharge summary for further enhancement

We were informed of the same and the operation took place on Friday 13/11/09. Before the operation we had seen the approval letter of TTK. After operation was over the final bill was sent to them for Rs. 27407 for which the reply by fax came as under

Authorisation – Approved dt 13/11/09
Authorisation limits- 10,000
Remarks- This is the full and final approved which supersedes all previous approvals.
(Maximum sum payable for cataract as per policy agreement. Non medical expenses are not payable to be collected by party)

The hospital would not let us go without paying them, Rs. 17407 and I had to pay the same to keep a good relation with the doctor.

As a reader of your column at first instance, I think it would have been proper for the hospital to claim from TTK as per earlier commitment. They did not as they have already a claim of Rs .10 lakhs due with them. Please take TTK to task for false commitment and not ethical business tactic.
Sir I would also like to tell you that had I known that the limit is only Rs. 10,000 I would not have got the operation done there, I would have done somewhere near my house. When TTK knew that they can only pay Rs. 10000 maximum against my policy then why did they commit Rs 15000 and also the further bills on vouchers. We have faxed and written letters to TTK and they have replied back by saying that the policy is entitled for Rs.10.000/-
Please help and guide.

Yours truly,
SS Eswaran
D-02, Indraprastha Appartments
Plot no-114, I.P extn
Patpargunj Delhi-110092
[protected]

To Anand D. Senthil,
Age : 34 Years
TTK Card Number : CHE-NI-GH[protected]A
Policy No. :[protected]
Claim submitted through West Bank Hospital, Howrah, West Bengal
Operation date : 26.11.09

Sir,
In reference to the above, I would like to inform you that in spite of the case being approved, I had to discharge the patient with full payment because of the delay in processing on your part. I also had to postpone the operation twice before because of the utter callousness on your part and I had to go through a lot of harrasment in the whole process. I didn't know that harrasment is a part of TTK's policy. We had called you at least 10 times on 28.11.09 and everytime the operators said that the case is still in process. The hospital had submitted the papers(break up in patient bill and discharge summary) at around 12 noon but the final approval didn't reach the hospital by 5.30 pm, the closing time of their administrative division in spite of the assurance on your part that it would definitely reach you by 5.30 pm. It being Saturday I had no other way but to discharge the patient by making the cash payment or I had to wait till Monday for further clarification. On being called one of your operators told us that the approval had been cleared but it could not sent due to software problem. I don't know if these kind of problems arise at the time payment only. I don't know if this is the way you deal with the party. Now you have got everything you required for this case to be approved and I would expect my money at the earliest. What else should I send you to get my payment? And I would also like to inform you that in the in the previous claim of the same patient I was supposed to get a disbursement of Rs 2000 something(according TTK Kolkata Branch) but I am still to receive it. And my credit card is credited every year faithfully on 1st April as premium to be harrased again and again. Would you please provide an immediate clarification to all the above?
Nirmalya Chakraborty

TTK No.- MUM-NC-A[protected]A

I have submitted two(2) claim forms in the month of September 2009 for the delivery through ceasarian in Chennai. The calim forms are forwarded to my AFL Pvt Ltd, Regional office Chennai, to be forwarded to my Head Office who inturn have submittedm the claim to Mumbai TTK Office. Till date we have not received the claim settlement. Kindly expedite an early reply form my request. Thanking you in anticipation. kindly reply to to my email-id / mob.no.[protected].


Chithralekha S
Regional Manager South
AFL Pvt. Ltd.
Chennai

Dear Sir,
I am holding a valid TTK Health Care card issued by the Chennai branch, which is "Cashless" in nature. Though my husband and I moved to Kochi in 2006, we have been maintaining the health card year after year by renewing the policy at Chennai.
In 2008, when I suffered a heart ailment, my husband rushed me to Amrita hospital in Kochi and they would not admit me because TTK Health Care card issued in Chennai was not acceptable to them, though this hospital is in the approved list of TTK Health Care.
They insisted that my husband should advance Rs 15,000 from his pocket, which was paid to them "in cash" considering the emergency and I gained admission in the Emergency Ward.
TTK Health care was immediately notified both over the phone and in writting regarding the problem faced my me in the non- acceptance of their Medi-card.
Later, upon enquiry with the top management of the hospital, my husband was informed that TTK Chennai card was not being honoured because TTK Chennai was with-holding some payments to the hospital in respect of earlier patients !
Therefore, in addition to the initial advance of Rs 15,000, it is pointed out that during the first 4 days of hospitalization, my husband had to procure medicines by cash purchase from the hospital's dispensary.
On the day of discharge, the hospital with-held Rs 7049 from the amount I advanced stating these are non - medical items. Upon verification of the items, I observed the items are Lab tests done at the hospital as per attending Dr's advise, nursing expenses for me, test strips used to monitor blood sugar levels as per Dr's advise, surgical items used at the ICU, etc. Therefore, from the total deduction of Rs 7049, after ascertaining the non medical items, I submitted a claim for Rs 5239 to TTK Chennai alongwith the original bills.
For the last 11 months, TTK Healthcare Chennai is being most lethargic in their attitude and avoiding the reimbursement of my genuine claim, though I have been repeatedly emailing them on this issue, but they just don't bother to redress the situation.
I would appreciate if you could kindly intervene and advise them to reimburse my claim and not to treat policy holders in this manner.
Thanking you,
Mrs Usha Susan Thomas

Sir,
We have booked the courier to Baddi on 14/10/09 at pallavaran. The consignment no:C23865333 and it was not reached till date. The other consignment sent on 26/10/09 to the same company has been received on28/10/09. What happend to the previous consignmet? I have been register the compaint through phone on 27/10/09 and the complaint number is 1363709. The customer care service informed us that they will contact us within 24hrs.Till now they didnot contact us.
Please inform us the status of our consignment