Dedicated Healthcare services TPA (India )
Complain ID : CC16483 83 Complaint's Reply
Insurance Complaint
Complaint Date : March 14, 2016
Sir
My name is Jaswant singh. I am working in intime equities ltd from last 7 years. My employee code is j1028. I am covered by our group medicalim insurance co. our insurance co is Dedicated Healthcare services TPA (India ) pvt. Ltd. My policy no is 500100/48/15/41/0000307. before 3 months ago I was met with an accident on my bike. In this accident my teeths were broken. I called my insuarce co about the claim they said u are coverd in this policy u will get the benefit of policy. I have the recording of the customer care reprensentative but now the insurance co has refused to give me the claim. They are telling the dental is not covered in this policy. Pls tell me if I suffered wid an accident my teeths were broken my insurance co is misguiding me. Pls help me in this matter. . Pls help me on this matter. I am very poor man it is very much difficult for me to pay this money pls help me.
Regards
Jaswant singh
M: 9988052927
My name is Jaswant singh. I am working in intime equities ltd from last 7 years. My employee code is j1028. I am covered by our group medicalim insurance co. our insurance co is Dedicated Healthcare services TPA (India ) pvt. Ltd. My policy no is 500100/48/15/41/0000307. before 3 months ago I was met with an accident on my bike. In this accident my teeths were broken. I called my insuarce co about the claim they said u are coverd in this policy u will get the benefit of policy. I have the recording of the customer care reprensentative but now the insurance co has refused to give me the claim. They are telling the dental is not covered in this policy. Pls tell me if I suffered wid an accident my teeths were broken my insurance co is misguiding me. Pls help me in this matter. . Pls help me on this matter. I am very poor man it is very much difficult for me to pay this money pls help me.
Regards
Jaswant singh
M: 9988052927
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Complaint against DHS TPA by tejal bari:
(4 of 5)
This is with reference to your Repudiation letter wherin DHS has rejected my claim dt 08th Aug 2016 regarding the mentioned claim DHS16Z154966 which states the treating doctor is BHMS and had given allopathic treatment hence claim got rejected under clause 2.25.
However i would like to mention that the treating doctor Mr Mahesh Prasad is a MD in medicine and DNB(Nephrology) FISN. Hence he is eligible to prescribe allopathy medicines and there is no violation of clause 2.25.
The Hospital where the treatment is taken is Dr ML Dhawale Rural Homoepathic Hospital. But since there are no hospitals nearby for kidney patients the hospital trust has taken up social work of providing allopathy medicines for kidney patients.
Mr Chandrakant Bari who is taking treatment in this hospital is a physically handicapped patient and hence not able to travel long distance for checkup. Hence he is taking treatment in this hospital as it is nearby to our residence.
After having a talk about with Mr Karan, TPA Officer on toll free number they are not willing to pass this claim on the above attachment.
Kindly look into this matter at the earliest and advise accordingly for getting claim passed.
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