Submitted by: vinit17
Complaint Details:
Dear Sir
I have Insurance Policy no 272200/48/2017/20476 dated 09.01.2017 in the name of Vinit Gupta.I have taken this policy since 2012 around 6 years back continuously paid premium on time .
I have taken claim on this policy in the year 2017 as per the details follows and the document is also attached under :
Date Amount Claimed(in Rs) Copay deducted(in Rs)
09-February, 2017 24, 104 (Cashless claim) 2, 323
01-March-2017 544 (Reimbursement) 60
07-April, 2017 38, 250 (Cashless claim) 4, 250
14-April, 2017 1, 818 (Reimbursement) 202
Total Claimed amount 64, 716 6, 835
Unclaimed Balance 2, 05, 284 23, 165
(2, 70, 000 – 64, 716) (30, 000 – 6, 835)
The Patient Mrs. Santosh Gupta(Mother) was hospitalised in Maharaja Agrasen Hospital on 29.09.17 in emergency at night
due to OTHER ACUTE ISCHAEMIC HEART DISEASES . And was discharged on 1-October-2017. The Bill amount was made
for Rs 2, 41, 102 and the total Claim was received amounted Rs 1, 84, 398 . According to my Unclaimed Balance Rs 2, 05, 284 and Copay Rs 23, 165, I should have Received the Total amount of Rs 2, 05, 284 but received Rs 1, 84, 398 only. So The Balance unclaimed amount left is Rs 20, 886 (Rs 2, 05, 284 – 1, 84, 398) .
So Please send remaining amount of Rs 20, 886/- as soon as possible as my bill is in the UNDER DISPUTE STATE.
Also According to my Policy I have no deduction on claim except the 10% copay and this has been mention on your website database for my policy no and the copy of same is attached under.
Also I have sent a no of mails previously but no Reply has been given till yet. And Even the Call-Center representatives didn’t gave me a satisfactorily reply. Due to This I also have to face problem during discharge due to your unresponsive staff.
So See to the Matter carefully i have mailed on daily basis from 1st Oct 17 but no reply received till yet and Process my request asap or I have to take the legal way for this.
Regards
CA Vinit Gupta
Mobile: +91-[protected]
48-B, Kewal Park Ext, Azadpur
Delhi-110033
Email ID: cavinitgupta@gmail.com