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Reconsider Mediclaim settlement
28-Sep-2023 (In Insurance Law)
Sir
Aroyagyan policy since 2016 is inforce at Uiic. Recently i approached ENT doctor for severe cold Simotoums. Doctor examine& suggest nasal surgery is required for this case.
I ready to prepare take to go surgery .with Reimburment method. Because that hospitaln is not tie up HI TPA . After successful surgery I was submit all necessary documents to sent Health Insurance TPA. They asked & rasied number of queries. We clearly all reqired documents submitted to TPA. But final they ask one more query rasied treating doctor report how nessessary surgery. He can reply this case may be congenital. Patient need surgery . The HI TPA was reputed claim by couse of its congenital.
All the health insurance policies issued subject to terms and conditions.
more particularly if an insured person gets treatment from an hospital which is no tied up with them, they raise number of queries to avade their liability. you are suggested to approach a good Advocate in your locality and get issue a legal notice through him to the insurer calling him to reimburse the expenses you incurred and if even the insurernot responds, file a complaint before your district consumers disputes redressal forum (Consumers Court).
more particularly if an insured person gets treatment from an hospital which is no tied up with them, they raise number of queries to avade their liability. you are suggested to approach a good Advocate in your locality and get issue a legal notice through him to the insurer calling him to reimburse the expenses you incurred and if even the insurernot responds, file a complaint before your district consumers disputes redressal forum (Consumers Court).
Helpful?
Adv. Kadagala Rambabu Naidu
Srikakulam | 200+ Answers
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