[Resolved]  Vipul Medcorp — Rejected bams doctor claim...

Address:	Pune, Maharashtra, 413102
Website:	www.vipulmedcorp.com

Under policy no : 361601/46/15/[protected] fileno 16rb01naa7924.Vipul medi corp rejected cliam by saying doctor degree was bams.
Reason of hospitlization: maternity.
Doctor degree : bams
Claim amount: 45000/

There is no any rule mentioned on there website
http://www.vipulmedcorp.com

While intimation i told doctor name/degree. Please help me to pass the claim.

There is no such rule clearly mentioned to reject bams doctor, if this is the case then bams doctor should not get the licence/hospital id/registration no.

References:
Irda circuler given on http://www.vipulmedcorp.com

Rule no 9 in irda circuler...
9. Hospital
A hospital means any institution established for in- patient care and day care
Treatment o f sickness and / or injuries and which has been registered as a hospital with
The local authorities, wherever applicable, and is under the supervision o f a registered
And qualified medical practitioner and must comply with all minimum criteria as
Under:
- has at least 10 inpatient beds, in those towns having a population o f less than
10, 00, 000 and 15 inpatient beds in all other places;
- has qualified nursing staf[censored]nder its employment round the clock;
- has qualified medical practitioner (S) in charge round the clock;
- has a fully equipped operation theatre o f its own where surgical procedures are
Carried out
- maintains daily records o f patients and will make these accessible to the insurance
Company’s authorized personnel.


The indian medical council act

http://www.mciindia.org/actsandamendments/themedicalcouncilact1956.Aspx

21 : 1. The council shall cause to be maintained in the prescribed manner a register of medical practitioners to be known as the indian medical register, which shall contain the names of all persons who are for the time being enrolled on any state medical register and who possess any of the recognised medical qualifications

2: h. "recognised medical qualification" means any of the medical qualifications included in the schedules.


Please help me to pass the claim.