Non-payment of insurance claim for 10 months

I had the benefit of medical insurance for my parents from my company from United Insurance. As per process, I had raised a claim with Medicare TPA for an unfortunate hospitalisation for my mother in October 2009. Even after repeated followups and emails to senior management in Medicare TPA, they are still to process this claim. It has been over 10 onths now and no revert from them. Continue reading

Unjustified Denial for mediclaim

Today’s Date: 16 Feb 2010
Policy number: 2825 300 280 48 Claim Number: 4272620 Claimant Name: Late Mr. Dev Raj Suneja
Covered under Mediclaim: Since 2005
Claim details: Case filed in July 09
Denial letter received in Late Dec 2009
Ground of denial: Preexisting disease
Applicant complaint: Unjustified denial due to following reasons:
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Reimbursement Services. – Mediclaim Policies of National Insurance Co. Ltd.

J.A.C. Vincent,
B.Com (Hons), DBM, MMS.,
“GAJ-GAURI” – Ist Floor, 30/A, Tatya Tope Soc.,Wanawadi, Pune – 411037.
Cel: 9823263428
Feb 6, 2010

Shri R.K. Vashistha, Insurance Ombudsman, Email & Copy by Post
Office of the Insurance Ombudsman,
Email:ombudsman@vsnl.net
Jeevan Seva Annexe III Floor, S.V.Road, Santacruz (W), MUMBAI-400 054

Dear Sirs,

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mediclaim

dear sir/ma’am,

Insurance claim has not been paid since last year. We have sent all the papers and still there is no progress in my file. You all never give a response in a phone call, and the call center always claims that my case is in progress. Please let me understand why it takes a long time to receive money from Medi-claim. My policy number: 4034/hir/02729616/00/000

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