Digitally privided post hospitalization rejected for post hospitalization claim
Complain ID : CCN056448 85
Insurance Complaint
Complaint Date: January 20, 2022
This is Jio.Insurance by broker edelweissfin.com insurer is Universal Sompo; and TPA Ericson tpa. Ref Claim id : 160035- Post hospitalization documents were submitted within 60 days elecronically as the web site of ericson TPA says to submit. And I asked to confirm if these were in order and ok. On delay in settlements I was told to send paper copies which I sent. Claim rejected due to delay in submission.
No where in home page, policy or anywhere does it say:
1. Hardcopies have to be submitted
2. Pre and post bills are allowed for a period 60 days of discharge, it DOES not mean that is the due date for submission. No where does the policy says that post hospitalization papers have to be submitted in 60 days. If I have a bill on 60th day of discharge, how can It reach you on 60th day.
No responses on emails by TPA and Broker Edelweiss and all calls to TPA states we shall respond and never respond
No where in home page, policy or anywhere does it say:
1. Hardcopies have to be submitted
2. Pre and post bills are allowed for a period 60 days of discharge, it DOES not mean that is the due date for submission. No where does the policy says that post hospitalization papers have to be submitted in 60 days. If I have a bill on 60th day of discharge, how can It reach you on 60th day.
No responses on emails by TPA and Broker Edelweiss and all calls to TPA states we shall respond and never respond
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