Location/place: KOLKATA
Name of company/service: GENINS INDIA TPA LTD. / NATIONAL INSURANCE CO. LTD.
MY MOTHER (AGE 61 YEARS) HAD BEEN ADMITTED AT BELLE VUE CLINIC ON 12.10.12 DUE TO SEVERE DIARRHOEA & WEEKNESS. SINCE HER SUGAR LEVEL & PRESSURE LEVEL WAS FALLING, OUR HOUSE PHYSICIAN HAD ADVISED US TO IMMEDIATELY ADMIT HER. AS SUCH LOOKING AT HER CONDITION, SHE WAS IMMEDIATELY RUSHED TO BELLE VUE & ADMITTED IN HDU UNDER DR. S.K.BISWAS. SHE WAS RELEASED ON 16.10.12. SINCE THE TPA GENINS INDIA WAS NOT APPROVED FOR CASHLESS IN BELLE VUE CLINIC, WE HAD TO PAY ALL THE DUES TO RELEASE MY MOTHER FROM HOSPITAL & DULY SUBMITTED ALL THE BILLS WITH ALL NECESSARY SUPPORTINGS TO NATIONAL INSURANCE CO. LTD. OUR TOTAL BILL AMOUNT WAS RS.50028/’- OUT OF WHICH ONLY RS.24587/- WAS RELEASED THRU NEFT TOWARDS FULL & FINAL SETTLEMENT BY THE TPA. THE BALANCE AMOUNT OF RS.25441/- WAS DEDUCTED FOR VARIOUS REASONS. THE REASONS WERE NOT ACCEPTABLE TO ME & I FEEL THEM TO BE UNJUSTIFIED & THEREAFTER HAD WRITTEN A LETTER TO GENINS INDIA VIDE LETTER DATED 09.01.13 (RECEIVED BY THEM ON THE SAME DAY) WITH A COPY TO NATIONAL INSURANCE (RECEIVED BY THEM ON 11.01.13). AFTER THIS AGAIN WE RECEIVED ANOTHER LETTER DATED 11.02.13 FROM GENINS INDIA (RECEIVED BY ME ON 07.03.13) MENTIONING THE SAME REASONS & INFORMING THAT THE CLAIMS ARE NOT PAYABLE. SINCE THE LETTER CONTENT WAS VERY BRIEF & NO ADEQUATE JUSTIFICATION PROVIDED WHATSOEVER, I WAS COMPELLED TO INFORM THE MATTER TO NATIONAL INSURANCE. AS SUCH I HAD LODGED A COMPLAINT LETTER DATED 26.02.13 BY REGISTERD POST WITH AD ADDRESSING TO THE CHAIRMAN-CUM-MANAGING DIRECTOR OF NATIONAL INSURANCE COMPANY LTD. & THE LETTER HAD BEEN RECEIVED BY THEM ON 27.02.13. HOWEVER ITS ALMOST TWO MONTHS, BUT WE HAVE NOT RECEIVED ANY REPLY FROM NATIONAL INSURANCE.
WE SEEK YOUR HELP TO RESOLVE THIS ISSUE SO THAT WE ARE NOT DEPRIVED OF OUR OWN CLAIMS.
Leave a Reply