Dear Sir/Madam,

Complaint:

I’m a Customer of TTK Healthcare TPA Pvt Ltd., since 30-11-2007 and I pay 15000 p.a
as premium. My Policy Number 4063/hap/04257919/00/000. According to my policy, TTK
has certified that Rs.8,000 p.a will be reimbursed as opd claim if I submit
necessary receipt and bills for the same and I’m eligible for Rs.2,00,000 if
hospitalized. TTK has also promised both opd claim as well as hospitalized claim
amount will be paid through cheque in 21 days from the date of bills, receipts and
documents sent.

I got admitted on 27-06-2009 in “Shree Venkateshwara specialty Hospital” for severe
pain in abdomen and fever. That was the first time I got pain in abdomen and as per
Doctor’s Instructions I underwent surgery called “Laparoscopic Cholecystectomy” in
same hospital that took me Rs. 42,015.

Though I was having the claim facility in my Organization where I was working at
the time of my surgery, I wanted my claim to be done by TTK only, Considering TTK
promised to pay in 21 days. I submitted all my Original Documents with bills and
receipts to TTK office in Bangalore branch itself on 8-7-2009 and they confirmed
that the Cheque will be dispatched on 1-8- 2009. I got a letter from TTK on
12-8-2009 demanding for some more documents which really made me depressed,
therefore I Called TTK Customer service for the reason why it took more than a
month for them to let me know “Documents Needed”, No one responded properly. Any
how I went back to the same hospital and collected the document on 18-8-2009 and
sent it to Mumbai branch immediately through my expense itself. Again I confirmed
with the customer service in Mumbai, they promised that I will be receiving my
cheque on or before 20-9-2009, I myself called Customer service to check status on
my payment yet to receive from TTK on 23-9-2009, I was told It’s still in process,
on 25-9-2009 again I was told that the Documents are through from their side, the
payment will be done on or before 2-10-2009. I have made several calls and sent
mails in this regards till 27-9-2009 I was told that the claim is in process, will
receive the payment shortly. On 28-9-2009 I got a call from Mumbai branch, they
said “To claim Hospitalized amount the Insurer has to be a customer for more than 2
years and since my policy is not 2 years old, it has been rejected”.

If I’m not eligible for the claim why did I get a letter for “ documents more
required” and was told that my claim is under process from past 3 months 20 days,
If I was told this before I would have applied in my previous working organization
which I resigned recently on 19-9-2009. Till date I have been depressed for the
delay in payment and spent my time and money making STD Calls to Mumbai Customer
service 022-29240860.

Request:

Required my applicable claim of Rs.42015 from the Insurance company and penalize
them for their negligence, depression caused for the period of 3.2 months, right
value for my money and time spent on the process.

Thanks and regards

Syed Munver

9901908080

I am a corporate employee and my father was admitted for the severe Kidney disorder, in which 90% of his kidney is not working. I submitted a big bundle of all the papers, reports, bills, discharge summary, prescriptions etc to them. Firstly, the extra qualified doctors of TTK says my father whose cretinine level is 5+ and is suggested to go for dialysis by various hospitals in Delhi is normal. Then they say, to claim it we require 2years past history reports, to find the root cause analysis of the problem.

It is quite surprising that to reimburse the current bills they require 2years old paper!

I dont have those papers, what should I do I don't know. I am very frustated as I am not able to help my parents in their need

In cases of Non-networked hospital treatments they are bound to do such mischeif. I am Dr. Raviprakash (Surgeon). My patients have several such problems, now we are slowly overcoming them. Get in touch with me. My cell no. is 9448120373. Alternatively you can also contact my advocate friend Mr. Sanjay D. cell No. 9448300242

Dear Sir,

Please see below details -

Name of Patient - Dr. S.R. Billore (my father), TTK Card (BLR-UI-D0299-002-0000081-A)
1st Oct 2011 - Three frequent asthmatic attacks
3rd Oct 2011 - Admission to Agarwal Hospital (Hospital ID HOS-MUM-3250). The TTK Card was presented to the Hospital soon after admission, with a request of cashless treatment.
5th Oct 2011 - I was informed by the Hospital that they are unable to contact TTK after a number of attempts (no response on Fax / E-mail).
5th Oct 2011 - I wrote an e-mail to preauth@ttkhealthcareservices.com; care@ttkhealthcareservices.com, reporting this problem.
5th Oct 2011 - I could somehow contact the TTK Call Centre who informed me that Cashless is not possible, and suggested me to settle the bills which will be reimbursed later.
6th Oct 2011 - My father was discharged. However, I was not having enough cash, but due to my goodwill with the Doctor, I got my father discharged without paying the bill. Later, I paid the bill in bits by cash, and ultimately collected the original papers & bills from the Hospital. This was also delayed due to a foreign tour of the Doctor who had to sign a few documents.

It took me more than two months to gather the funds, follow-up with the Doctor and ultimately submit the claim to TTK. But after a long wait and continuous follow-up, I was shocked to know from TTK that the claim has been rejected.

In the first place I was not given a cashless option, and later when I somehow settled the bills from my pocket, the claim was rejected despite timely informing about the admission and due correspondence from my side.

I request you to kindly get me Justice in this case.

Kind regards,
Manish Billore
Bhopal

Heavy Reduction in mediclaim by TTK

Name of patient S.Sivaraman

CL NO COM 0512 CL 0000072
policy no 720403/34/11/01/00000085 New india assurance
Hospitalisation two days

SURGERY OA LATERAL COMPARTMENT AND PATELLOFORAL RIGHT KNEE ARTHROSCOPIC SURGERY

Out of claim of Rs 82113 only Rs 32370 being settled citing a very common reason as THE RATE APPLICABLE TO ENTITLED CATEGORY

FOR EG

Details Claimed Settled

ICU CHARGES 3500 2000

Asst Surgeon Charges 12500 1563

Anaesthetist Charges 2500 313

Consultation 500 62

Consultation 2 1400 175

LAB INVESTIGATIONS 585 73

OT CHARGES 4000 500

PHISIOTHERAPY CHARGES 350 44

SURGEON cHARGES 20000 2500


It seems TTK doesnot want to settle the genuine full amount. Rather they have approx 25% target to settle. iAM A POLICY HOLDER FOR THE PAST 14 YRS AND PAID FAMILY PREMIU OF MORE THAN Rs 90,000and this is the way they treat policy holders. Let them go and get admitted in city hospitals and see for themselves the hospital charges. A ORDINARY CARPENTER CHARGES Rs 500/ DAY . Or the insurance co. while taking policy should give the settlement standards of TPA RATHER THAN MAKING A FOOL OF THE POLICY HOLDER. i AM THINKING OF SENDING THE CHEQUE BACK TO THEM

SIVARAMAN
94433 49981

I'm saravanan belongs to jasmin-info tech pvt.ltd chennai. I want do eye operation for mother . So i can do the operation or not by using ttk insurance policy

Dear Sir/Madam,

Complaint:

I am a corporate employee and having Insurance policy with TTK Healthcare TPA Pvt Ltd. for my family members, since 18-05-2011. My Mother was admitted for the Cataract surgery on 07-07-2012. Her policy number is CHE-NC-Z0046-001-0000433-E. I have submitted all the bills (Rs.22,500/-) and necessary documents to TTK.
I got a letter from TTK (Dt.13/12/2012) demanding for some more documents for the treatment undergone. I went back to the same hospital and collected the documents and sent it to Chennai branch immediately through courier on 26-12-2012.
I myself called Customer service to check status on my payment yet to receive from TTK on 28-01-2013, they said “To claim Hospitalized Amount the Insurer has to be a customer for more than 2 years and since my policy is not 2 years old, it has been rejected”.

If I am not eligible for the claim why did they send a letter for “Documents more required”. Till date I have been depressed for the delay in payment and spent my time and money making Calls to Chennai Customer service.

Request:

I request you to kindly get me Justice in this case to get my applicable claim amount of Rs.22500/- from the Insurance company and penalize them for their negligence, depression caused and long time spent on the process.

Thanks and regards

Karuppanan AV

9443201999

Dear Sir/Madam,

Complaint:

I am a corporate employee and having Insurance policy with TTK Healthcare TPA Pvt Ltd. for my family members, since 18-05-2011. My Mother was admitted for the Cataract surgery on 07-07-2012. Her policy number is CHE-NC-Z0046-001-0000433-E. I have submitted all the bills (Rs.22,500/-) and necessary documents to TTK.

I got a letter from TTK (Dt.13/12/2012) demanding for some more documents for the treatment undergone. I went back to the same hospital and collected the documents and sent it to Chennai branch immediately through courier on 26-12-2012.

I myself called Customer service to check status on my payment yet to receive from TTK on 28-01-2013, they said “To claim Hospitalized Amount the Insurer has to be a customer for more than 2 years and since my policy is not 2 years old, it has been rejected”.

If I am not eligible for the claim why did they send a letter for “Documents more required”(shortfall notice). Till date I have been depressed for the delay in payment and spent my time and money making Calls to Chennai Customer service.

Request:

I request you to kindly get me Justice in this case to get my applicable claim amount of Rs.22500/- from the Insurance company and penalize them for their negligence, depression caused and long time spent on the process.

Thanks and regards

Karuppanan AV

9443201999