I hold a mediclaim policy with The New India Assurance Company for my mother.
Name: Sudha Saraf
Mem No.: 02I00257923B
DOB / Age: 15th Sept. 1953 / 55
Policy No.: 511600/34/08/11/00003362
Period from: 31/03/2009
Period to: 30/03/2010
My mother was admitted in AMRI Hospital, Kolkata for a surgery (Hysterectomy - Removal of Uterus) under Dr. Pranob Dasgupta.
The total Bill for the hospitalization was Rs. 1,37,825/-
On submission for \"cashless\" claim, the total permissable claim granted by \"Medicare TPA Services (I) Pvt Ltd\". Kolkata was only Rs. 50,000/-. Although the insurance cover for the above mentioned policy is Rs. 1,50,000/- with accumulated bonus of Rs. 50,000/- for 1st 1 lac and Rs. 2,500/- for next Rs. 50,000/-
We as a family hold 3 Mediclaim Policies with your company and I or my father have been paying premium from past 14 yrs for the 3 insurance policies. We are actually surprised to learn that our first claim in last 14 yrs of paying premium deligiently has resulted in such a disappointment wherein total claim passed have been approx 1/3rd of the submitted claim. The reasons given to us by Medicare TPA is unsatisfactory and falling short on all expectations.
We are actually deliberating, whether to continue paying premium henceforth and hence request your intervention in giving us some clarity on the expectations we can have in future.
dear sudha
pl mail me policy name of new india, and other policy name and no. and how old policy do you have,
All of puc general insurance company had add caping on health policy i.e you can not use full amount, you will use 50% of sum insuread at one time only, and also having caping on room rant,consultating charges,pre and post hospitalzation,pl provide me all detail of urs policy then sugest better option for you
my cell no:0********72 and email id: shahaji.patil@apollomunichinsurance.com
1.Incomplete details.
2.One than more policies, did intimation contained all policy numbers?
3.any previous claims
4.have u submitted final total claim within stipulated time
5. have u approached the Insurers-complaint officer
An email communication has been sent to New India Assurance Co on July 11, 2009, 2:14 pm
TTK account 112000/34/10/1100003654
Tel No ********70
Dear Sir,
I am a regular premium payer under the above policy no which is as per records. I had followed the procedure as required when my wife Arakkal Shali Joffy was hospitalized starting from faxing the intimation, handing over of documents in 10 days period at your office at Morol.after which I was regularly following up when I finally got to know that it is under varification 22th of October and later finalized for cheque preperation in Nov 28.
Sometimes I get feed back that this policy no does not exist, secondly it is surprising to note that you keep shifting your office and no information on the bordline is made available which is un acceptable from a reputed organization likes yours.
This is with ref to my TTK account 112000/34/10/1100003654 wherin I had been informed from Nov 28nd that my cheque is being prepared but till date yet the same statement.
Kindly look into it and revert back to me on the same as I need to forward the mail to IRDA informing them of the same for records and further action.
Regards
Arakkal Joffy Joseph