Irda — for settlement of mediclaim with tpa agency medi assist

Address: Surat, Gujarat, 394112

Dear sir,
I am naishadh purohit and writing you for the following reason.

This is for claim id 16951463 for the policy no 310605/50/[protected] of national insurance

I was paining in abdomen on 04/04/2018 evening so, on 05/05/2018 i consulted radiologist named "shail" and sonography was carried out during sonography and x - ray. Then i contacted dr. Sanjeev c shah for the further treatment. He advised to get c t scan and other blood tests. Doctor advised to hospitalize for the reason to be operated for stone in lower lo in to be removed. I was hospitalized on 05/05/2018 and discharged on 08/04/2018 with an advise that stent removal is balance and within a week time readmit in the hospital and stent will be removed. Accordingly i was re admitted and stent was removed. I have intimated medi assist on 6th april for the hospitalisation.

Further, all documents were submitted to surat office on 24th of april and i was informed that the claim will be settled down fortnightly. To my utter surprise on 8th may i have received a massage that we acknowledge the receipt of your claim document on 08/may/2018 10:58. Tracking number for your reference is ahm00017955. There after a search i was on conclusion that my claim id is 16951463 and was told that within 05 working days my claim will be settled. Almost a month has passed without settling my claim.

I was waiting and waiting for the deposition of claimed amount of rs. 1.13 lakhs and all of a sudden the claim status as"information awaited". For what sort of information needed is not known to me.

You are requested to settle my account as early as possible being a common man the huge amount i have incurred for the operation. My son has passed 10th class just this month and i have to pay his fees in school as well for the tution class.

Regards,
Naishadh
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My father is admitted to hospital due to malaria. I am trying hard to get claim number from mediassist who is tpa for national insurance. But with various means I am not able to get claim I'd also. This is very frustrating and ridicuy.
I have taken mediclaim of National Insurance through Bank Of Baroda Mosali branch near Surat as I am living at Township of GIPCL. On 3rd April I was told to move on towards Charanka for office work. So, I moved towards Charanka and while staying at Vadodara for to attend the meeting on 5th April at our corporate office. Unfortunately during the stay in night at Vadodara I was suffered from the abdomen pain and consulted radiologist in the matter and Dr. Sanjeev C Shah o[censored]rocare hospital, Vadodara. As per the advise from Dr. Sanjeev C Shah I was admitted in Uro care hospital for the removal o[censored]retic stone.

I was hospitalized on 05/05/2018 and discharged on 08/04/2018 with an advise that stent removal is balance and within a week time readmit in the hospital and stent will be removed. Accordingly i was re admitted and stent was removed. I have intimated medi assist on 6th april for the hospitalisation.

As per the custom I have intimated TPA Agency medi assist on 6th April regarding hospitalisation. For submitting documents I asked on telephone to Ahmedabad representative . He told that form the medi assist web portal down load the form and as per the instructions given in the form submit all documents to Surat office. Accordingly I have approached his office on 18th of April. At the time I was advised that the form B is balance to submit. I asked for the availability of form from website, He told that it is not on the portal. You may get this form from other site and issued us a form B. He checked other documents and asked for the validation or authentication of reports with a seal stamp and signature of Doctor. As I am living near to Surat, again I have to return back to Vadodara and got the reports sealed and signed with filling form B from the doctor and submitted all documents with previous year policies from inception period on 24th of April' 2018. They issued receipt as an acknowledgement for receipt of documents. While asking for the settlement of the claim they told that within 15 days you will be answered for claim settlement. So from 18th to 24th six days wasted.
After 15 days on 8th of May' 2018 I received a massage from IX-MBUDDYthat they have received documents on 8th of May and the tracking no is AHM00017955 and successive massage informed for claim no is 16951463 with an intimation within 5 working days. So total 21 days wasted.

On 6th of June on my utter surprise I got a massage that they need some documents as policy documents from inception time which is already submitted to them on 24th April to their branch office.

Second documents for the medical treatment taken for the same kind of treatment for which I have put the claim which I have never taken.

Third document is Internal case papers from the Urocare hospital with hospital seal and signature. The concern Dr. is out of country and may come in July.

So total no of days wasted till today are 45 days. My claim was for Rs. 113616.00 is not settled even after 45 days.

You are requested to look in the matter and settle my claim as early as possible

Regards,
Naishadh

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