The details of the claims are as under : 1. Claim for Rs.38930/- dated 09-03-2011 for hospitalize of Mother during the period 22-12-10 to 28-12-10 at Santokba Durlabhji Memorial Hospital cum Medical Research Institute, Jaipur against Happy Family floater policy No.224502/48/2010/384. a. Following documents are enclosed i. Claim form ii. Medical Bill dated 28-12-2010 for Rs.30930/- (Rs.4000 paid advance and balance Rs.26930/- deposited with UBI, Hospital Bank A/c on 28-12-2010) being the normal procedure for clearance of Hospital Bill. iii. In patient discharge summary iv. Camberwell Diagnostics & Medical Research Centre MRI bill Rs.8000/-dated 10-12-2010 – Pre Hospitalization Medical Bill v. Okay Diagnostics Research Centre MRI Report dated 23-12-2010 vi. Copy of Policy vii. Copy Insurance communication for condoning delay in submission of claim as the caretaker was busy at Hospital for further treatment of the patient. viii. We has submitted confirmation form hospital also for clarification as in the process of the move from Jaipur to Delhi – Lucknow so papers were missed.

2. Claim of approx Rs.77000/- for treatment of Mother during 7th /8th January, 2011 to 10th August, 2011 at GB Pant Hospital, New Delhi submitted through my employer M/s Indo Gulf Fertilizers during August, 2011 against Happy Family Floater Policy No.224502/48/2011/253. a. Following documents were submitted to the Insurance Company but copy of the same could not be retained. i. Admission paper ii. Death certificate issued by the Hospital during treatment iii. Pathology and MRI receipt issued by Hospital iv. Medical bill from Market v. Few copies of Medical papers on which we could have access and Xerox for claim. vi. Consultancy charges issued by other Doctors at Delhi and Mumbai. 3. Claim of approx Rs.27000/- for treatment of Father for cataract operation during August, 2011 at Anand Eye Hospital, Jaipur submitted through Indo Gulf Fertilizers during August, 2011 against Happy Family Floater Policy No.224502/48/2011/253. a. Following documents were submitted to the Insurance Company but copy of the same could not be retained. i. Admission paper and discharge certificate issued by the Hospital during treatment ii. Medical bill from Market The above claim of father was submitted to OIC instead of claiming it with Rajasthan Government, based upon discussion & confirmed before operation by Mr S D Dewedi . Even after submission OIC has never confirmed by letter that papers are being returned so that we could have claimed with Rajasthan Government.

Complainant Information
name- sanjaykd