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Pintu Maurya (Accountant )     13 June 2013

Mediclaim reimburshment

Respect Sir

I have took the mediclaim pocily form one of Govt insurance company this year my 3rd year policy. sir i have file a claim procedure on one of TPA in mumbai. 5th March 2013 maxisum time of claim recived is45 days but since more than 90 days gone, but i have not received any claim amount. there after i have logde a complain in IRDA they have given me 16 days time to company. in between TPA person contact me they ifnorme me my original file was mislpace. now they are asking me for resubmission xerox copy of document. sir i ahce some xerox copy but not all. when i told to them give me letter i will asked to hospital to provide copy to me they are not ready to give in writing and ready to give me only 50 % amount in cash agaisnt of whlole settlement . one of employee of TPA is try threting me if i will not accept 50 % andnot take complain back they will not give any amount and raising so many quetion like proived doctor medicine prescripttion, hospital bill etc and reject your claim. sir i do not have copy of doctor medicine prescripttion, hospital bill. plz sujjest me what to do in this situation.  plz plz help me. i will thankful for your co-operation.    



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 2 Replies

jayakumar.R (ADVOCATE & LEGAL CONSULTANT)     13 June 2013

 

 File a consumer complaint before consumer tribunal forum 

Pintu Maurya (Accountant )     14 June 2013

soory sir i am not get it to you. consumer complain means, where in consumer court or some where else. because i already filed the compalin in IRDA.


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