New India Assurance — health insurance

Address: Medak, Andhra Pradesh, 502032

Subject: ghpl tpa - new india assurance health insurance claim rejected with improper / silly reasons

Dear sir / madam,

Health insurance claim rejected with improper / silly reasons by new india assurance company. I am holding medical insurance policy from good health plan ltd (Ghpl) which is third party administrator (Tpa) and the insurance company is new india assurance company.

My wife has undergone surgery of laprohysteroscopy and pcod treatment and processed for claim. The claim got rejected. The treatment which i had is usa fda approved treatment. For this treatment almost all insurance companies are accepting and reimbursing the money.

Mediclaim reference number: 800539
Claim with ghpl id no: ghna[protected]
Claim amount: 37000 rs.
Tpa person: masrath baigh - mobile: [protected]
Ghpl health id: ghna[protected] (Policy holder)
Policy number:[protected]
Claim ghpl id: ghna[protected] (Patient id)

Ghpl did not provide any details for what all medical treatments they covered and for what all did not. I am continuously following up ghpl tpa customer care through online and offline but they are not yet all replying to my mails. With silly reasons they are saying that the claim got rejected. I heard from media that few insurance companies pay incentive to tpas based on rejection of claims.

Please help me in this how to get the claim processed and refunded?

I am appreciating for the help.

Thanks & regards,
Anjaneyulu pasupuleti,
Aurobindo pharma ltd,
Hyderabad
Aplrc - ii (Ard validation),
Emp id: 34124
Office:[protected]
Mobile:[protected]