Dear Sir,

I have taken a mediclaim policy from Raksha TPA for Rs. 1,00,000.00 for myself, my wife and my daughter on 12th Nov 2009. But unfortunately my daughter-9 years old was admitted to Bangalore Baptist hospital on 21.12.2009 to 30.12.2009 due to severe stomach pain and Vomitting. After a week they diagnised she is suffering from accute pancreatitis and she under went ERCP and 10MM stone was removed from the Bile Duct. We have submitted all the bills to Raksha TPA but they denied giving the claim telling it is a pre-existing disease. But even her doctor confirmed that it is highly impossible to say it is preexisting disease. Please let us know whether I can file a complaint against Raksha TPA for the claim.
regards
S VIVEKANANDAN

please reply at the earliest

Since past few months my approved claim of Rs.75,000/= with ready cheque lying with Raksha is not sent or paid to me. My ID:BN1118706 has been alloted to me by Raksha.

Whenever i phone Raksha office the person on the line says that soon my cheque for Rs.75,000/= is going to be dispatched but nothing happens later.

This undue delay and lack of proper action by Raksha is depriving me of the amount of claim for using to buy more medicines for my treatment which is still going on.

Best wishes

Prakash T. VASU

Originally Posted by Prakash Vasu

Since past few months my approved claim of Rs.75,000/= with ready cheque lying with Raksha is not sent or paid to me. My ID:BN1118706 has been alloted to me by Raksha.

Whenever i phone Raksha office the person on the line says that soon my cheque for Rs.75,000/= is going to be dispatched but nothing happens later.

This undue delay and lack of proper action by Raksha is depriving me of the amount of claim for using to buy more medicines for my treatment which is still going on.

Best wishes

Prakash T. VASU

Kindly post your complaint in date wise, so that we can guide you accordingly.

I Mr. Purnendu Shah with the policy no. 122300/48/09/14314 would want Raksha to understand the background of my case that clearly indicates that i am not a user of tobacco however doctor with some misunderstandings mentioned tobacco usage in the consulting letter which we have cleared as untrue in every stage of the procedures. I would want to mention that i was just using IPICO tooth paste(which is stated unharmful). I would want to notify you that i have already corresponded with RakshaTPA and oriental insurance company. With reference to clause no.4.8, they rejected my mediclaim which donot apply to my case. In the past i have never claimed mediclaim for any kind of diseases. All this years from the day i am been insured, my agent never acquainted me with the reasons for rejection of a claim. please help us with your kind support.

I Mr. Purnendu Shah with the policy no. 122300/48/09/14314 would want Raksha to understand the background of my case that clearly indicates that i am not a user of tobacco however doctor with some misunderstandings mentioned tobacco usage in the consulting letter which we have cleared as untrue in every stage of the procedures. I would want to mention that i was just using IPICO tooth paste(which is stated unharmful). I would want to notify you that i have already corresponded with RakshaTPA and oriental insurance company. With reference to clause no.4.8, they rejected my mediclaim which donot apply to my case. In the past i have never claimed mediclaim for any kind of diseases. All this years from the day i am been insured, my agent never acquainted me with the reasons for rejection of a claim. please help us with your kind support.
From:
Purendu Shah
15/Vishwaprakash,
Sahakar nagar,
j. p Road,
Andheri(west)
Mumbai-400053

Sir,
My fimilies are covered under group insurence thru co. Recently my wife has been admitted Apllow Hospital-Mysore.
Cashless treatment cannot be done as we do not have pacent ID no. I have been adviced that we pay first & discharged pataint & then claim with documents.

We are four member family. I have my mediclaim insurance since last fifteen yrs whereas my son and my doughter have been added just six years back. My son was facing headache problems since last three month where I admitted in a private hospital for thourough check-up after consult with the doctor. We also have city scan of my son.

We have not received reply so far fro Raksha TPT.

We are four member family. I have my mediclaim insurance from United India Insurance Co. Ltd since last fifteen yrs whereas my son and my doughter have been added just six years back. My son was facing headache problems since last three month where I admitted in a private hospital for thourough check-up after consult with the doctor. We also have city scan of my son.

We have not received reply so far fro Raksha TPT. I have sent all my bills to Faridabad office.

My name is Amit Dalotra I am in Smart chip Ltd & i have medical insuarance of mine & my wife . I have policy no is 221504/48/09/41/00000898 claim of Rs 8536 against my bill but they dont pay it .They give reason that you dont inform us during hospitilasation the period of admission is on 16/06/2010 to 22/06/2010.Raksha had sending mail please send your claim with in 15 days of discharge.I am not getting my claim i am not satisfied with this company.



Amit

We have not recieved quickly app. From R.TPA..

Never purchase a policy from thats company which tpa is raksha , raksha only make fool to all customer , they never reply to any email never settle easy any claim........

1] Instead of Mr. Hiren.H.Gala you have writen Mast.Hiren.H.Gala make the correcion and post me new card.
kindly do the needful.
2] Instead of Priyanka. Hiren.Gala you had writen Priyanka.Hiran.Gala make the correcion and post me new card.
kindly do the needful.

Dear Sir/Madam,
I had my left eye’s cataract surgery conducted by Dr. Jugal Shah who practices at Maa Hospital in Malad (w) on March 17th. I have submitted the bill for that surgery to your organization which was of INR 63,100. I only got INR 40,000 reimbursed for my surgery. When I applied for the policy, I was not informed that certain percentage of my fees will be deducted and I will not be getting my 100% reimbursement.
I am accepting the above amount conditionally with a hope that your organization will reimburse me with the rest of the amount in my bill. I would request you to please do the needful. Please let me know if you need more information from my side.
Thanks,
my policy 110600/34/10/11/00000857
members id N9011361358 raksha tpa pvt ltd

Dear Sir/Madam,

My son has taken above corporate policy and I contacted Yashoda Hospital , Secunderabad for treatment of swelling in my 3rd fingure of right hand on 21.10.2011. Dr. G Laxmana Shastry advised me for a minor surgery . The neccesary application along with Doctor's report were sent to Raksha TPA for approval on 22.10.2011 , but they have refused on 24.10.2011 giving reason that causmetic surgery is not covered under the Insurance. I explained them that this is not a causmetic surgery as may be verified from the concerned doctor . The surgery is required to prevent further swelling in my fingure and other complications afterwards.

I request the concerned authorities to look into the matter and take necessary action at the earliest.

Thanks

Hira Lal Srivastava
Secunderabad