Medical Claim

Location/place: LUDHIANA

Name of company/service: BHARAT IT SERVICES LTD

My Name is Hari Krishan S/o Shimru
My Mobile No.09256071621.

My Medical Claim is pendding from May,2012 That is Amount Rs:61035.

As discus all mail insert below:

From: Asif Ali [mailto:[email protected]]
Sent: 22 December 2012 10:13
To: Jassa Singh Kharg
Cc: Sunder Lal Jain; Payal
Subject: Re: Request Letter for Reopening Medical Claim File_______Claim of Mr. Hari Kishan employee of Bharat IT Services Limited 54551213025909

Dear Sir,

We request you to please kindly give us your valuable approval to process the claim.

Thanks & Regards,

Asif Ali
Raksha TPA Pvt. Ltd.
C/o Escorts Corporate Centre,
15/5, Mathura Road,Faridabad
Mobile:0-7838151581
Office:0129-4289999
Fax:0129-4289988
Website: www.rakshatpa.com

“Stay Healthier with Us”

—– Original Message —–

From: Asif Ali

To: Jassa Singh Kharg

Cc: Sunder Lal Jain ; Payal

Sent: 2/11/2012 12:32 PM

Subject: Fw: Request Letter for Reopening Medical Claim File_______Claim of Mr. Hari Kishan employee of Bharat IT Services Limited 54551213025909

Dear Sir,

Greetings from Raksha TPA…

With reference to claim of Mr. Hari Kishan employee of Bharat IT Services Limited this is to inform you that after scrutiny of the claim few queries were raised, details are mentioned below.

Claim no. 54551213025909

1 Copy of MLC/ FIR.

2 Original Breakup of main hospital bill.

3 Original investigation reports DURING HOSPITALISATION (XRAY REPORTS ,ECG,MICROBIOLOGY,BIOCHEMISTRY,PATHOLOGY AND ULTRASOUND REPORTS) dated 18/04/2012,25/04/2012 .

4 Treating Doctors certificate mentioning detailed circumstances and mode of incidence.

5 Treating Doctors certificate mentioning history of intoxication if any.

6 Treating Doctors certificate mentioning personal history/ habits eg. Smoking, tobacco chewing , alcohol, drugs etc., if any.

After sending three consecutive reminder letters we have closed the case as per non receipt of reply in the stipulated time frame.

Now the insured has submitted the documents, we need an approval for re-opening and for further processing.

We request you to kindly give us your valuable approval to process the claim.

Claim Number
54551213025909

Member Id
UIC545DC416SPNL

Unique Policy Number
250500/48/11/41/00000583

Insured Name
Hari Kishan

Patient Name
Hari Kishan

Relation
Self

Re-imbursement
Re-imbursement

Claim Amount
61035

Date Of Admission
18-Apr-2012

Date Of Discharge
25-Apr-2012

Hospital Name
Dayanand Medical College And Hospital-Ludhiana -Tagore Nagar, Civil Lines -Fax:- 01612304250

Current Claim Status
File Closed

Thanks & Regards,

Asif Ali
Raksha TPA Pvt. Ltd.
C/o Escorts Corporate Centre,
15/5, Mathura Road,Faridabad
Mobile:0-7838151581
Office:0129-4289999
Fax:0129-4289988
Website: www.rakshatpa.com

“Stay Healthier with Us”

—– Original Message —–

From: “Payal”

To: “‘Asif Ali’”

Cc: “‘Pradeep Parashar’” ; ;

Sent: 29/10/2012 11:57 AM

Subject: RE: Request Letter for Reopening Medical Claim File

> Thanks Asif.
>
> Will appreciate an early response.
>
> Thanks
> Payal
>
> —–Original Message—–
> From: Asif Ali [mailto:[email protected]]
> Sent: 26 October 2012 16:00
> To: Payal
> Cc: ‘Pradeep Parashar’
> Subject: Re: Request Letter for Reopening Medical Claim File
>
> Dear Madam,
>
> Thanks for the mail, this is to inform you that it will take some to time
> process the claim since it has already closed. We will send the request to
> insurance company for the approval of re-opening shall process the claim as
> soon as we receive the approval.
>
> Thanks & Regards,
>
> Asif Ali
> Raksha TPA Pvt. Ltd.
> C/o Escorts Corporate Centre,
> 15/5, Mathura Road,Faridabad
> Mobile:0-7838151581
> Office:0129-4289999
> Fax:0129-4289988
> Website: www.rakshatpa.com
>
> “Stay Healthier with Us”
> —– Original Message —–
> From: “Payal”
> To: “‘Asif Ali’”
> Cc: “‘Pradeep Parashar’”
> Sent: 26/10/2012 12:59 PM
> Subject: FW: Request Letter for Reopening Medical Claim File
>
>
>> Dear Asif
>>
>> Pl treat this mail as request for the reopening of mediclaim file of Mr.
>> Hari Kishan detail of which is as below:
>>
>> MemberId: UIC545DC416SPNL
>> Policy No: 250500/48/11/41/00000583
>> Insured Name: Hari Kishan
>> Claim in respect of: Hari Kishan
>> Relation: Self
>> Claim Ref No :54551213025909
>>
>>
>> Pl do the needful and update accordingly.
>>
>> Thanks
>> Payal
>>
>>
>>
>> —–Original Message—–
>> From: Hari Krishan [mailto:[email protected]]
>> Sent: 26 October 2012 10:03
>> To: Minhas Sir
>> Cc: satbir.s; payal.v
>> Subject: Request Letter for Reopening Medical Claim File
>>
>> Dear Sir
>> My medical claim is not clear because this file is
>> closed automatically system.
>> All documents are already completely submitted. All detail is
>> mentioned in mail. but But Raksha TPA is required Reopening Request
>> Letter from insured Company (M/s Bharat IT services Ltd.).
>> I need the money. because treatment is pending of
>> my wife. She is admit in
>> hospital early according to consulted Doctor.
>>
>> Kindly clear my medical claim early.
>>
>> Thanks
>> With Rgds
>> Hari Krishan
>> DC-416
>>
>> ———- Forwarded message ———-
>> From: Hari Krishan
>> Date: Sat, 20 Oct 2012 17:52:37 +0530
>> Subject: Fwd: FW: Claim Query Letter
>> To: “payal.v”
>> Cc: “satbir.s”
>>
>> Dear Mam
>> I have sent regular mail to you. But You are not reply
>> me. I phone called on 19-oct-2012, You said that this case is old.
>> But Raksha TPA is required Reopening Request Letter
>> from insured Company (M/s Bharat IT services Ltd.)
>> Because All documents are submitted. For other details
>> please check all mails.
>>
>> This request Letter is delay from you.
>> Kindly provide the Reopening Letter to RAKSHA TPA, to the behalf of
>> insured Company (M/s Bharat IT services Ltd.).
>>
>> Thanks
>> with Rgds
>> Hari Krishan
>> DC-416
>> ———- Forwarded message ———-
>> From: Hari Krishan
>> Date: Thu, 20 Sep 2012 09:27:40 +0530
>> Subject: Re: FW: Claim Query Letter
>> To: Satbir Singh , “payal.v”
>>
>>
>> Dear All
>> Good morning
>> Please any update.
>> Please clear claim early because i need to money.
>> Thanks
>>
>> with Rgds
>> Hari Kirshan
>> DC-416
>>
>> On 9/14/12, Hari Krishan wrote:
>>> Dear All
>>> Please request reopening file to Raksha TPA from insured
>> company
>>> Thanks
>>> With RGDS
>>> Hari Krishan
>>>
>>> On 8/30/12, Hari Krishan wrote:
>>>> Dear Sir/Madam
>>>> I and my Mrs. had been faced an accident together
>>>> since April 18,2012. My Mrs. Was again admitted in hospital on June
>>>> 25,2012 and discharged July 26, 2012. For this reason my all family
>>>> members were tensed because my resident location is 30km far from
>>>> hospital. My permanent address is v.p.o. haripur khalsa tehsil
>>>> phillaur distt. Jalandhar. During my treatment I was on bed. So I
>>>> could not provide all pending important documents and I could not
>>>> check claim status.
>>>>
>>>> But now all important documents are competed and all original
>>>> documents already sent to following address by courier:
>>>> To
>>>> Mr. Rohtash Kumar (H.R.)
>>>> Mrs. Payal Varma
>>>> M/s. BHARAT IT SEVICES LTD.
>>>> C-10, SEC-65,
>>>> NOIDA-201301 (U.P.)
>>>>
>>>> From DTDC COURIER LTD, Document No. Z68162922 DATED 30-07-2012.
>>>>
>>>> So kindly clear my claim because I need money for pending/next plastic
>>>> surgery
>>>> treatment.
>>>>
>>>> Permanent Contact No:92560-71621
>>>> Permanent Address : Hari Krishan S/o Simru, V.O.P. Haripur Khalsa,
>>>> Tehsil -Phillaur, Distt. Jalandhar, Punjab.
>>>> Permanent E-Mail ID : [email protected]
>>>> HDFC A/c No. 14211050009476
>>>>
>>>> Thanks
>>>>
>>>> With Rgds.
>>>> Hari Krishan
>>>> DC-416
>>>> Ludhiana
>>>>
>>>> On 8/30/12, Satbir Singh wrote:
>>>>> FYI
>>>>>
>>>>>
>>>>>
>>>>> Satbir
>>>>>
>>>>>
>>>>>
>>>>> From: Rohtash [mailto:[email protected]]
>>>>> Sent: Wednesday, July 11, 2012 9:44 AM
>>>>> To: Satbir Singh
>>>>> Cc: [email protected]; [email protected];
>>>>> /@zimbra142.megavelocity.net
>>>>> Subject: Re: Claim Query Letter
>>>>>
>>>>>
>>>>>
>>>>> Dear Satbir,
>>>>>
>>>>>
>>>>>
>>>>> for your information and confirm to Mr. hari kishan
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>> Thanks & Regards
>>>>> Rohtash Kumar
>>>>> (HR Deptt.)
>>>>> Bharat IT Services Limited.
>>>>> (Formerly Spicenet Limited.)
>>>>> Head office: C-10, Sector 65, Noida-201301 UP.
>>>>>
>>>>> —– Original Message —–
>>>>>
>>>>> From: [email protected]
>>>>>
>>>>> To: [email protected] ; [email protected] ;
>>>>> [email protected]
>>>>>
>>>>> Cc: [email protected] ; [email protected] ;
>>>>> [email protected] ; /@zimbra142.megavelocity.net
>>>>>
>>>>> Sent: Tuesday, July 10, 2012 4:23 PM
>>>>>
>>>>> Subject: Claim Query Letter
>>>>>
>>>>>
>>>>>
>>>>> System Generated Mail.Do not Reply to this mail ID
>>>>>
>>>>>
>>>>>
>>>>> Ref No. :54551213025909/22
>>>>> Dated: 10-07-2012 04:25:52 PM
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>> To,Corporate Manager,
>>>>>
>>>>> Bharat IT Services LimitedC-10, SECTOR-65, NOIDA, GHAZIABAD, UTTAR
>>>>> PRADESH-
>>>>>
>>>>>
>>>>> SUB :Claim File Closed
>>>>>
>>>>>
>>>>>
>>>>>
>>>>> _____
>>>>>
>>>>>
>>>>> MemberId
>>>>>
>>>>> :
>>>>>
>>>>> UIC545DC416SPNL
>>>>>
>>>>>
>>>>> Policy No
>>>>>
>>>>> :
>>>>>
>>>>> 250500/48/11/41/00000583
>>>>>
>>>>>
>>>>> Policy Period
>>>>>
>>>>> :
>>>>>
>>>>> 19/11/2011 to 18/11/2012
>>>>>
>>>>>
>>>>> Insured Name
>>>>>
>>>>> :
>>>>>
>>>>> Hari Kishan
>>>>>
>>>>>
>>>>> Claim in respect of
>>>>>
>>>>> :
>>>>>
>>>>> Hari Kishan
>>>>>
>>>>>
>>>>> Relation
>>>>>
>>>>> :
>>>>>
>>>>> Self
>>>>>
>>>>>
>>>>> Claim Ref No
>>>>>
>>>>> :
>>>>>
>>>>> 54551213025909
>>>>>
>>>>>
>>>>> Dev Officer/Agent Code
>>>>>
>>>>> :
>>>>>
>>>>> 250500/060
>>>>>
>>>>>
>>>>> Hospital Name
>>>>>
>>>>> :
>>>>>
>>>>> Dayanand Medical College And Hospital
>>>>>
>>>>>
>>>>> Claim Amount:
>>>>>
>>>>> Rs.61035
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>> Dear Sir/Madam,
>>>>>
>>>>> Kindly refer to our Letter No 54551213025909/22 Dated 10-07-2012
>>>>> 04:25:52
>>>>> PM
>>>>> regarding toyour claim.
>>>>>
>>>>> This is to inform you that above-mentioned insured has filled a claim
>>>>> regarding treatment undertaken and the following documents were
>>>>> required
>>>>> :
>>>>>
>>>>>
>>>>> 1
>>>>>
>>>>> Copy of MLC/ FIR.
>>>>>
>>>>>
>>>>> 2
>>>>>
>>>>> Treating Doctors certificate mentioning detailed circumstances and mode
>>>>> of
>>>>> incidence.
>>>>>
>>>>>
>>>>> 3
>>>>>
>>>>> Treating Doctors certificate mentioning personal history/ habits eg.
>>>>> Smoking, tobacco chewing , alcohol, drugs etc., if any.
>>>>>
>>>>>
>>>>> 4
>>>>>
>>>>> Treating Doctors certificate mentioning history of intoxication if any.
>>>>>
>>>>>
>>>>> 5
>>>>>
>>>>> Original investigation reports DURING HOSPITALISATION (XRAY REPORTS
>>>>> ,ECG,MICROBIOLOGY,BIOCHEMISTRY,PATHOLOGY AND ULTRASOUND REPORTS) dated
>>>>> 18/04/2012,25/04/2012 .
>>>>>
>>>>>
>>>>> 6
>>>>>
>>>>> Original Breakup of main hospital bill.
>>>>>
>>>>>
>>>>>
>>>>>
>>>>> -Claim In Query By Doctor was sent on 17-May-2012
>>>>> -First Reminder was sent on 06-Jun-2012
>>>>> -Final Reminder was sent on 23-Jun-2012
>>>>>
>>>>>
>>>>> But, we are sorry to say that till date no proper reply has been
>>>>> recieved
>>>>> from your end. Hence file has been closed and no further correspondence
>>>>> will
>>>>> be entertained.
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>> Regards,
>>>>> For RAKSHA TPA Pvt.Ltd.
>>>>>
>>>>>
>>>>>
>>>>> _____
>>>>>
>>>>>
>>>>> 2nd Floor, SCO181, Sector-7C, Chandigarh (U.T.)-160019, PHONE:
>>>>> 0172-5008705,
>>>>> 5008716, 4634707,
>>>>> FAX: Cashless-011-66173411, Others- 0172-5008722,

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