United India Insurance Company [UIIC] — regarding the claim number[protected]

 
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Srikrishna Sai Esha Legend, ----select----, India
 Venkatesh.s.s on Jan 14, 2020
Hi girija,
I am a wipro employee and having medical insurance with 'united india insurance company limited'.

Regarding my claim 99984478,
1) claim amount is rs. 592499. I have base plan of 2 lac with topup cover of 6 lac. And as per the policy i can claim total 8 lac for one of my family member as there is no such restriction.
My daughter was to be admitted for minimally invasive caediac surgery for asd closure. Hence myself and start hospital had already intimated the insurance company about the scheduled hospitalisation.
Star hospital, hyderabad had provided estimation of expected cost of rs. 536000/ and provided the details of surgery and other relevant expenses as part of pre hospitalisation. Insurance company had transferred rs. 180000 to hospital for the initial instalment.
At the time of discharge, insurance company did not agree with the claim amount and type of surgery and declined to pay the remaining claim amount of rs. 387000.
As per the rule, if we are doing surgery with mics (Minimally invasive cardiac surgery charges rs.100000/-excess of package), in some cases, this amount will not be paid by insurance company.in this case, i am expecting rs. 287000 should be processed by insurance company.
But they processed only rs 99000.

2) start hospital submitted the claim at 4 pm on[protected]. And insurance company taken time of 5 hours to settle this partial claim amount. (9 pm)
If its a cashless claim, why they need this much time? Customers are sufferring a lot with this service.

Regards,
Venkatesh
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    United India Insurance Company [UIIC] - regarding the claim number - 99984478