New India Assurance — claim under mediclaim policy not fully settled. deduction of 42%

Address: Chennai, Tamil Nadu, 400101
Website: www.mdindia.com

Cashless request for ccn:tp[protected] approved with a deduction of 42% by md india. Policy number 712500/34/17/21/00000006. Mdid no: mdi5-[protected]

On[protected], my sister underwent a bilateral knee arthoscopy and knee ostetomy at shrushrusha hospital mumbai.in the begining itself the hospital had given an estimated cost of rs.5.50 lakh. When a claim for cashless approval was sent to md india, they approved an amount for the claim. At no point of time did they mention that there would be a 42% deduction on the final bill. Only on the day of discharge, we were surprised to note that they had deducted 42% from the final bill amount and we had to personally pay rs.240487/- to seek discharge. Bill raised by shushrusha hospital was for rs.575437/- and md india approved the claim only for rs.334950/-. This was a big shock for us. Further when we enquired reasons for the deduction they mentioned certain caps which were never informed to us in the first place. They also mentioned that if the insurance company authorises them to make the payment they would settle the claim in full. However, the customer care at new india was not very helpful and asked us to take up the matter with md india itself. Since discharge had to be taken on the same day we were compelled to pay the amount to the hospital. I now request you to examine this matter and authorise md india to settle the bill in full.
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