DAY CARE AYUSH (TREATMENT BY AYURVEDA THERAPIES) CLAIM REJECTED BY THE INSURER
Complain ID : CCN032381 28
Insurance Complaint
Complaint Date: May 16, 2019
- State : Uttar Pradesh
- City : Agra
- Address: House No. 89, First Floor, Kalindipuram Colony, Mau Road, Dayal Bagh, Agar
MY SELF RAJEEV KUMAR MISHRA IS THE HEALTH INSURANCE POLICYHOLDER OF SWASTHYA KAWACH WIDER FAMILY PLAN OF IFFCO TOKIO GENERAL INSURANCE COMPANY LTD. SINCE 2010 without missing any due premium.
On the prior information and taking claim id-Claim No. 2018070500014.R1 to our insurance company i started to take regular 12 Days (4th June 2018 to 16th JUNE-2018) AYURVEDA THERAPIES TREATMENT from its impaneled hospital DALCO HEALTHCARE CENTER-DELHI and paid total bill of Rs.33224/- against this treatment.
And when i submitted my claim with IFFCO TOKIO GENERAL INSURANCE and provided them all needful information as required but after 4 months discussions the company rejected the claim on the ground that i have taken OPD TREATMENT only, so they can not provide its claim.
Now as a consumer i feel cheated by this way of professional behavior of the insurance co.
Here the Hospital is in good way, because i have paid them all bills and the Insurance company is enjoying because from last 10 years i am paying them regular annual premium, Just the consumer (Myself)is in threat due to this claim rejection behavior of the Insurance co.
Insurance co. says i have taken OPD treatment not IPD and have not share with them the No. of Beds in Hospital.
In this regards the DALCO HOSPITAL SAYS that they are NABH APPROVED HOSPITAL FOR AYURVEDA THERAPIES and all the therapies take 1-3 hours for a decided time period of 7 days, 10 days, 15 days or 30 days by ministry of AYUSH and it is performed in DAY CARE treatment. So the HOSPITAL IS REGISTERED to perform day care treatment so they cant mention the No. of approved Bed even they are having any No. of bed.
On these the counsumer is suffering and missing the valu and trust with Health Insurance Company.
Please do justice on my appeal.
Thanking You
With Regards
Rajeev Kumar Mishra
(Iffco Tokio Kealth Insurance Policy No. 52817581, Claim No. 2018070500014.R1
Mob. No. 09319090190
On the prior information and taking claim id-Claim No. 2018070500014.R1 to our insurance company i started to take regular 12 Days (4th June 2018 to 16th JUNE-2018) AYURVEDA THERAPIES TREATMENT from its impaneled hospital DALCO HEALTHCARE CENTER-DELHI and paid total bill of Rs.33224/- against this treatment.
And when i submitted my claim with IFFCO TOKIO GENERAL INSURANCE and provided them all needful information as required but after 4 months discussions the company rejected the claim on the ground that i have taken OPD TREATMENT only, so they can not provide its claim.
Now as a consumer i feel cheated by this way of professional behavior of the insurance co.
Here the Hospital is in good way, because i have paid them all bills and the Insurance company is enjoying because from last 10 years i am paying them regular annual premium, Just the consumer (Myself)is in threat due to this claim rejection behavior of the Insurance co.
Insurance co. says i have taken OPD treatment not IPD and have not share with them the No. of Beds in Hospital.
In this regards the DALCO HOSPITAL SAYS that they are NABH APPROVED HOSPITAL FOR AYURVEDA THERAPIES and all the therapies take 1-3 hours for a decided time period of 7 days, 10 days, 15 days or 30 days by ministry of AYUSH and it is performed in DAY CARE treatment. So the HOSPITAL IS REGISTERED to perform day care treatment so they cant mention the No. of approved Bed even they are having any No. of bed.
On these the counsumer is suffering and missing the valu and trust with Health Insurance Company.
Please do justice on my appeal.
Thanking You
With Regards
Rajeev Kumar Mishra
(Iffco Tokio Kealth Insurance Policy No. 52817581, Claim No. 2018070500014.R1
Mob. No. 09319090190
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