Ref. no:- Memmber ID UIC8570934
Mediclaim Policy no. 081300/48/09/97/00000090
Development Officer Code 2/228
Policy Period 17-May 2009 to 16-May 2010
Claim no. 54522910147858
Claimant Mr. Deepak Gupta
Claim in Respect of Mrs Sangeeta Gupta (Wife)

Details of Hospital:- Hospital Name- Yashlok Hospital & Nursing Home P. Ltd.
Date of Admission 19- Nov 2009
Date of Discharge 22- Nov 2009
Registration No. YHN-1089
Diagnosis Acute Appendicitis

Intimation Details:- Raksha TPA Faridabad,
Through FAX to FAX no. 01294289988
Date of FAX 19- Nov 2009
Time of FAX 8.29PM & 8.33PM

TPA M/s Raksha TPA
15/5, Mathura Road, Faridabad,
Haryana-121 003,

With reference to the above and our letter, in response to TPA mail dated 14.05.2010, for your kind perusal & necessary action on dt. 02.06.10, forwarded you by:-

The Divisional Manager,
United India Insurance Co. Ltd;
Divisional Office-1,
86, Hapur Road, Meerut

Dear Sir,

Most humbly the claimant regretfully wants to state that despite of my continuous efforts to approach to TPA & Insurance Company regarding the settlement of the claim, but till date the claimant is waiting for settlement of claim / or reply in response of letter.

The claimant is very sorry and fad up to write this mail, this type of action of TPA & Company is making bed image and impression in the mind of the claimant and they will have lost the faith of the policyholder.

That the Claimant had been intimated to TPA on 19-Nov 20009 details of which are mentioned above for you ready reference,

That, the claimant submitted the claim to the office of to United India Insurance Co. Ltd; Meerut on 06 Dec 2009, that is within 30days and time limit.

That the office of to United India Insurance Co. Ltd; Meerut; forwarded the claim papers to TPA on 05 Feb 2010. The claimant is not responsible for the delay to send the papers to TPA.

That, the reason of TPA for Non Payable the claim, on the ground of that the claim papers received by you after the expiry of 30days on 09.02.2009, is wrong and illegal,

Unfortunately even then response of TPA & Company is passive and till date the claimant have not received any communication. Its being more than five long months to wait for your positive response. Under these circumstances, it seems that TPA & Company is not taking keen interest to sort out the issue; however,

Further, I have sand the request mails to TPA (Raksha TPA), UIIC Co. Ltd.

For & on Behalf of Claimant

Vipin Jain
Consultant
Mobile no. 9927200431, 9690000698

CC to:-

The Divisional Manager,
United India Insurance Co. Ltd;
Divisional Office-1,
86, Hapur Road, Meerut