Non payment of due claim

Dear Sir, please read my mail and help me out.
Name of the complainant : Mr. Atul Chandra Dawn
Communication details :Lancha Mahal
Puratan Hattola
VILL + PO : Ukhra
Dist : Burdwan
State : West Bengal
Pin : 713363
E-mail : [email protected]
Mobile no. : +919832267919
Insurance Type : Non-life
Insurance Company Name : National Insurance Company Ltd
Date of birth of policy holder : 16-10-1968
Policy no. : 150403/48/11/8500002419
Agent Name : Mr. Amitaba Dhara
Agent Code : 9000253
Agent Mobile no. : +919832249897
Policy Serving Branch Code : Uni 150403
Dev Officer : 150403
Policy Serving Branch Address : Ajit Banerjee Building
Nachan Road
Post : Benachity
Dist : Burdwan
West Bengal – 713213
Telephone : 0343 2583670
Fax : 2586133
Details of the complaint : Sir I have a Hospitalization Benefit
Policy. Sum Insured is Rs. 5,00,000. The nominees assinged by me was my
wife and children(2). My wife underwent an Total Laparoscopic
Hysterectomy,Adhesiolysis at The Apollo Hospitals,Chennai. Both the
surgery and hospital comes under the coverage of the policy and the
company. The cost incurred for the surgery was Rs. 1,18,000. The TPA
sanctioned a claim amount of Rs. 1,06,000 after adjusting necesary
deductions and promised me to pay the sum. Firstly while I was
arranging necesary documents before the surgery the agent mis-guided
me by saying my policy is not coming under Cashless Card Benefit and
did’nt provided me the cashless card which I was supposed to get
according to the documents and forced me to pay in cash. Later on the
company cleared only Rs.47,010 of the claim by cheque and
denied to pay the rest amount which is Rs.58,990.
I have previously approached the company regarding this same complaint and they cleared only Rs.19,000, paid by
cheque & now again denying to pay the rest of the claim which is
Rs.39,000. The company authorities are not even interested in talking
to us. Please provide me a complain id and look into the matter and acknowledge my request.


Comments

Leave a Reply

Your email address will not be published. Required fields are marked *