Non payment /wrong deduction by tpa to hospitals

jayesh (Querist) 06 January 2012 This query is : Resolved
Hospital is giving cashless facility to patient. But in some cases, TPA(working on behalf of insurance co) denied payment and in some cases, made wrong deductions. What are the legal remedies against TPA ? Can we go to IRDA ? or other judicial authority ? How ?

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ajay sethi (Expert) 06 January 2012
if TPA has made arbitray deductions while settling bills you can move consumer forum against said TPA / insurance company for deficency in service .

Sankaranarayanan (Expert) 06 January 2012
Yes I do agree with mr sethi

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