Dear Sir/Madam, Claim Number: Insurance Company: National Insurance Co. Ltd. Policy No: Payment Details: Amount Claimed: 159527 Claim Paid: 115770 The deduction details received by me was not very clear, on enquiry I was told that under point No. 7 of the deduction summary (Rs.34900/- on Bill No.ipcs080813 dated 8/8/2013 (Consultant/Specialist) for 25% of dR HEAD) is valid as per you. But as per the rules 25% of the sum insured is for Dr. Head and 50% of the sum insured is for others including OT Charges. But according to the deduction summary the package of Rs.55000 for Operation (OT Charges) has been assumed under Dr. Head, whereas the same should be taken into consideration under the rest 50% of the sum insured. As per the commitment in the insurance papers I must get Rs. 34900 more than the settled amount. Rest all the deductions (other than point no. 7) are okay and I don’t have any issue related to the rest of the deductions. Please note that in the hospital bill the amount of Rs. 55000 has been clearly mentioned as “Packages / Surgery / Procedure (Pyeloplasty L6)” and charges for surgeon are separately mentioned under “Doctor Charges”. Kindly review the bills once more carefully and do the needful at the earliest. And if all the charges including the Package of Rs. 55000 has been taken into consideration for Dr.’s Head then what are the charges settled against Operation Procedure (OT Charges). Once more I request you to kindly do the needful at the earliest

Please settle the claim properly and pay me the amount of Rs.34900 wrongly deducted

Complainant Information
name- manoj e-mail manoj_mundra@live