Sir/Madam.
I,the undermentioned person wish to inform that my mother Sabita Sardar was admitted to R N Tagore Int Institute of Cardiac Sciences for chest pain.We sought cashless to PARAMOUNT TPA but the authority declined our request. Later, I had sent for reimbursement for the same
.Now the authority is saying this
“On scrutiny of the claim documents found this 60-yr old female patient was admitted with history of chest pain, was diagnosed to have antero-septal wall myocardial infarction, underwent Coronary Angiography. Hospitalization period was from 07/04/2014 to 11/04/14. As per available medical history found patient had a past medical history of hypertension & Diabetes mellitus & ECG & Blood test reports done during last year policy period revealed positive findings on those. Since current admission is the outcome of earlier history of hypertension & DM, which were detected during 2nd year policy period (Policy Inception on 29/09/11) the claim is considered for rejection as per policy clause No. 4.1.”
During the second year from the inception of the policy my mother was treated under a doctor for feeling unwell and we conducted tests suggested by the doctor .But the diseases as the TPA suggests are not diagnosed neither by the doctor nor during the inception of the policy as her policy was accepted after conducting medical tests and on the basis of the clinical investigations.
Therefore, I request you to look into the matter to have justice as early as possible.
thanking you ,
Sukumar Sardar
Leave a Reply