I am a group insurance holder of Iffco Tokio General Insurance Company Limited with PHS ID 21042593 Policy No. 52367946 My wife met with an accident and was admitted to hospital. I had filed a claim for the same FIR Number 2645637 for an amount of Rs. 21512.00 The amount passed is Rs.10996.00 after deducting an amount of Rs. 10516.00. In reference to mentioned case I would like to bring to your knowledge that amount has been wrongly deducted. First of all I never received a policy from company end so that I could know what policy contains and what restrictions were there. Secondly they have deducted an payment of Rs. 579.00 for delay intimation. Our hospital has intimated the company IFFCO Tokio on same date of admission 28th Nov. 2014. But they got the reply that intimation was to be given to Paramount TPA. As cards were issued by the company so they gave intimation to the company. On receiving reply from them they intimated Paramount on 29th Nov. 2014. Then how was the delay in intimation? Thirdly they have fined Rs.6435.00 as we have taken room with room rent higher than specified. We had no policy so how can we know room rent ceiling? The patient was female. Ours is a nuclear family and it is not possible for me to remain full time with patient as I have look after office as well as children. And if something wrong happened in semi-private room, who was to be blamed for it? How can we take a semi private room and share with a gent’s patient? They could have charged us the amount above the limits as mentioned in policy. We are ready to be bear excess charges (which you have already deducted). Now how can they charge such a heavy fine triple times the room rent, which is very illegal & unjustified? So I shall get back the amount of Rs. 6435.00 (fine) and Rs. 579.00 (late intimation charges).

The complete amount deducted + Rs. 3000.00 towards there wrong claim of not intimating on time. They themselves are wrong and proving us to be wrong.

Email Id: kushal.kalyani@gmail.