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DELAY IS SETTLING OF CLAIM

Complain ID : CCN043025   28  

Insurance Complaint Complaint Date: December 7, 2019
  • State :  Maharashtra
  • City :  Palghar
  • Address: P501 Durvas Chs Opp Dmart Nallasopara East
MY MOM (SUMAN DUBEY) WAS ADMITTED TO OZONE HOSPITAL ON 12TH OCT AND DISCHARGE OF 16TH OCTOBER 2019 THE TOTAL BILL WAS OF RS. 59337.
LATER WE HAD TO ADMITTED HER TO GLOBUS HOSPITAL AGAIN ON 22ND OCTOBER AND SHE WAS DISCHARGE ON 24TH OCTOBER. THE BILL OF THE HOSPITAL WAS 24423.
I HAD SUBMITTED THE CLAIM FOR RS 59337 ON 26TH OCOTBER AND CLAIM OF RS 24423 ON 01ST NOVEMBER. SINCE THEN THE TPA (MEDIASSIT) IS HARASSING EVERYTIME WITH THE EMAIL STATING THAT 1 DOCUMENT IS MISSING AND OTHER DOCUMENTS ARE MISSING. WHEN WE CALL THEIR CLIAM NUMBER 18004191159 THEY ASK FOR A NEW DOCUMENTS EVERYTIME. IT IS ALMOST A MONTHS TIME SINCE I HAVE BEEN CHASING THEM TO SRTTLE MY CLAIM. EARLIER THEY WERE BEHIND ME STATING TO RENEW MY POLICY WHICH I HAVE ALREADY DONE. BECUASE THEY MENTALLY TOURED ME FOR APPROX 15 DAYS FOR RENEWAL. HAD A CALL ALMOST EVERYDAY APPROX 5 CALLS IN A DAY. PLEASE ASSIST ME IN GETTING MY CLAIM SETTLED ON PRIORITY, BECAUSE IT WAS REIMBURSEMENT CLAIM AS THE TPA DOESNT HAS THE NETWORK COVERAGE IN MY AREA. ALSO I WOULD REQUEST A STRICT ACTION AS WELL. THE STAFF STATED ME THAT SINCE YOU HAVE PURCHASED THE POLICY ON LINE HENCE WE COULD NOT ASSIST YOU. AND CUSTOMER CARE IS OF MEDIASSIST HENCE THEIR IS NO PROPER TRACKING MECHANISM AVAILABLE FOR THE SAME. LOOKING FORWARD FOR THE REPLY AT THE EARLIEST.
Complaint Against / To: MANIPALCIGNA HEALTH INSURANCE COMPANY LIMITED

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