Hi,

I have got medical insurance policy of National insurance for the last 7-8 years.Policy Number-100200/48/11/8500000936.
Actually this year I am facing a serious problem while depositing my premium.I have deposited a Cheque.Cheque No:400941 on 20/6/2012.Amount Rs.1519.But there i have done a mistake in rupees amount while writing the cheque.Though National Insurance office of Behala,Tram Depot has accepted the cheque without checking the the cheque properly. Not only that they have also taken a service tax extra amount of 28 rupees by cash. But as there was a mistake in writing the cheque amount Citi Bank has not cleared the cheque.So I have receiveda call from agent.Agent, Code-944.So I immediately sent my wife to National Insurance office of Behala.Office Address-Div-II,1D,Diamond Harbour Road(Behala Trum Depot),1st Fl,Kolkata-700034.Account Officer Mr.Ratan fully Co-Operated and admit that there was a mistake from there part also as they have not checked the amount properly.So he told to deposit the amount by cash and he has also told while depositing the cash amount he will adjust the earlier cash of 28 rupees extra for tax.I was ready to pay the amount by Cash.But the Div Manager Mr.Ashis Dey of Behala office started shouting at my wife and behave very roughly and told that my policy is cancelled and they will not take the amount by cash since it has crossed the due date and if we are interested then we have to show all fit medical document from Apollo.He also instruct to go to Apollo Hospital for medical test.

why they have not checked the cheque properly?Why they have deposited the cheque to Bank?Why Natioanl Insurance behela accounts division accepted a faulty cheque which means they have not checked the cheque.So they are also guilty.

Now my question is this the policy of National Insurance to Harass customer like that? since they are also faulty.

Kindly help me and please solve this problem

Regards,

Ananda Shankar Chakraborty
M-9830246077

I, am Mr. Ketan Ghosalkar, an officer in Indian Air Force and currently posted to Jorhat, Assam. I had insured my bike in Gurdaspur, Punjab
(POLICY NO. 401500/31/11/6200005891) on 12 Nov 2011. The bike had met with an unfortunate accident and I had applied for the insurance claim in Jorhat, Assam. I had sent all my papers and the photograph of the bike was taken by the surveyor. All the relevant documents were given. I had inquired about the state of the claim and they said that they have sent the papers to main office in Sep 12. I had called on the telephone number of main office in Gurdaspur but I am getting only fax tone on it. Due to this I am also unaware of the state of my claim and don't know when will I get my money back.I had requested for status of my claim by sending mail on email-id of Mr kalra (rs.kalra@nic.co.) one of the company executive,on 01 nov 12, but I have not received any reply till now. I request you to please look into the matter and help me out as this is affecting my professional and personal life. I request you to get my claim cleared and get me adequate compensation for all the mental agony I have gone through in last 3-4 months.My account details are :

SBI account no. 31022143091

IFSC code: SBIN0002003

MICR code : 785002006

Branch code : 002003

With Regards
Ketan

REF:- Claim Status: Akash Joshi (1502604) - CCN : 2152190,
Policy number: 041200/48/12/41/00000228
PHS ID: 20728717
TPA: Paramount Health Services

Attachment: Rejection letter from TPA


Dear Concern,

My mother has been a patient of acute osteoarthritis form last 6+ years.
Doctors had advised her knee replacement or a shot of Durolane in both the knees since the xrays clearly showed a wide gap between her knees which was making her life difficult.
She was not even capable of getting up from the bed and walk.

Looking at the scenario, her regular orthopedics advised for knee replacement or injection shot as mentioned above.
Before getting admitted, I called up my TPA ( Insured through my corporate tie up ) and asked if this was covered under the insurance since the doctor has advised that the dosage is high and she has to be kept under observation.
They gave a go ahead for the same and based on that my mother was admitted to BOMBAY hospital, Indore.

The above incident happened on 08-Dec-2012 to 09-Dec-2012.Once doctor had the confidence, my mother was release.

Now after atleast 15 followups, the company came back with a rejection letter that the admission is not justified.
Now following are my queries \ concerns \ complaints:

1) When my doctor issued the notice of hospital admission, these folks agreed when I confirmed that the claim is payable.
Now they are rejecting on irrelevant grounds.

2) On what basis they are giving the reason that the patient was not required to be admitted.Due to the strong dosage, if anything unpredictable had happened to my mother, would these folks have taken the responsibility ?

3) If our doctor says its compulsory to get admitted and their doctors refuse, are we supposed to get treatment from the TPA doctors now and our doctors words hold no value ?

4) They asked for numerous documents which I kept providing for a period of 4 months and they still reject it.

5) Isn't this a scandal of earning money by agreeing first to pay the claim and later reject it on baseless comments.

6) My above mentioned TPA says that their doctors said that this should have been given in OPD.I asked them to talk to my doctor and convince him that he was wrong. But they are not even ready to do so.

Looking forward for some genuine help from you folks since these guys are here to just eat up our premium money and this is the second time in a year they are rejecting my claim.

Thanks in advance.

Warm Regards,
Akash Joshi
+91 9893567034