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United Healthcare — Insurance policy

I was with complaints of pain in l.s.region since 1 year, pain extending to both hip joint, diagnosed to have lumbar spondylosis. on going through submitted claim documents, it is observed that patient underwent siddha, ayurveda & alloid treatments like varma, thokkanam & exercise therapy. hospitalization for given line of ayurvedic treatment was justified on opd basis.

I got treated after getting proper information from the uhc team and raises the claim for the same.

When contacted the customer care on 05/04/16. i was informed as getting treated with a registered medical doctor in a registered hospital is always claimable. but the treatment taken on a opd basis and still the claim is rejected.

I have now spent a total of rs 36000/- including my travel, food and other expenses out of my pocket and now my claim is rejected.

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Updated by Vijaykumar v May 07, 2017
is there any action taken
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I have submitted medical document (dated[protected] of my wife Rinkee Singh for Claim no. 1214786 for re-imbursement for the amount of 40, 740/- before three and half month. My claim is still pending and I have been put in confusion yet. All verification has been done, even at my home patient verification also done. But still I have not been get the clear status of my claim. So many time I follow up with Ashish Saxena but every time I got different answer from him, I got fed up with this TPA. This thing really hurt me and my family, I have been working with the Capgemini/Igate company since around 6 years and touch wood never taken claim for myself, it’s for my wife second time of whole working life. As you know that Insurance premium paid by employee in my company, and I was sure that whatever expenses would be occur it will be paid by the Insurance company but I really get frustrated with this TPA. I mentally harassed in this three and half month and also get in financially shortfall due to emergency expenses occurred during my wife treatment. I have attached all mail communication during this claim reimbursement period. Please provide me the final status whatever is it, without delaying, also specified the reason for delayed three and half month.

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    Saidapet, Tamilnadu
    India

    Complaint categoryCategory: Insurance
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