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Raksha Health Insurance TPA Complaints & Reviews

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Updated: Feb 29, 2024
Complaints 235
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36
Unresolved
199
So far, so good. Raksha Health Insurance TPA is working on building a stronger response system and taking steps to address most of the complaints. While there's room for growth, their efforts show a positive trend in customer support. We hope Raksha Health Insurance TPA will keep up the work and continue to help more customers with their concerns even better 🤝
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Chandigarh tpa office for not settling claim of Sandeep Kumar Jyani pf 1359119
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During Hospitalization Expenses not being covered
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Claim put on hold due to requirement of documents

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Reimbursement pending for long time
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Raksha Health Insurance TPA reviews & complaints page 11

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Y
Yog Raj Pasrija
from Gurgaon, Haryana
Nov 11, 2014
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Non settlement of Mediclaim

Address: Faridabad, Haryana

Nov 11, 2014 Dear Sir, I filed a medi claim through Raksha TPA for United India Insurance Company as per the details below Claim No. [protected] Memberid UIC[protected] Unique Policy Number 221000/48/14/97/00000123 Insure Name Anita Pasrija Patient Name Yograj Pasrija Relation Husband Admission Date/ DischargeDate 25-SEP-2014 /25-SEP-2014 For the Treatmen of CATARACT RE Hospital Name Centre...
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Solanki Satish
from Vrindavan, Uttar Pradesh
Nov 1, 2014
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Mediclaim not received

Address: Jalore, Rajasthan

Dear sirs, my family mediclaim policy no. 243501/48/2014/1406 in name of Satish Kumar Solanki . My son Saksham Solanki suffering from full body pain till 09.09.14 to 27.09.14. I am submitt original bill & required document to Oriental insurance co ltd, Jalore office on 01.10.14 . I am not received claim in one month. How reason to Late claim please clearify. Please send claim of Rs 53974.80 immidiately & oblige . Satish Solanki. Email...
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Rajeev Ranjan
from Bangalore, Karnataka
Nov 1, 2014
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HORRIBLE SERVICE AND DEDUCTION OF PAYMENT

Address: Bangalore, Karnataka

i WAS ADMITTED IN SAGAR HOSPITAL, KUMARASWAMY LAYOUT, BANGALORE THROUGH CASHLESS FACILITY ON 29th OCTOBER 2014. INITIALLY I WAS SANCTIONED SOME AMOUNT. I WAS DISCHARGED ON 31st OCTOBER 2014 AND NECESSARY DOCUMENTS WERE SENT TO RAKSHA TPA BY THE HOSPITAL AROUND 1300HRS. BUT IN VEIN I DIDNOT GET ANY SETTLEMENT TILL LATE NIGHT. WHENEVER I ASKED ABOUT MY STATUS IWAS INFORMED BY THEM WITH IN 20-30 MINUTES I WILL GET APPROVAL. AFTER SOME TIME...
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A
Ashok Kumar Gandhi
from Gurgaon, Haryana
Aug 23, 2014
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Claim passed amount not being credited to my account

Address: Agra, Uttar Pradesh

I was passed (sanctioned) post hospitalisation claim but the same is not being credited to me by Raksha TPA despite number of reminders and telephonic calls. None of my e-mail is being replied by Raksh TPA, now they are not responding to my phone calls.I have spent heavy amount on phone calls. I am surprised how such companies are awarded with ISO, that stands for quality of services.

Policy No. [protected]P[protected]
Lata...
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ganesh ukirade
from Karad, Maharashtra
Jul 1, 2014
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no responce from tpa raksha for cashless

Address: Satara, Maharashtra

My policy number[protected] and member id number N90V002154VTIB Very very poor response from ur side for cashless approval and as well as I called Ur pune and mumbai customer care I am very upset from your service and My policy number[protected] and member id number N90V002154VTIB ganesh ukirde [protected]...
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D
dev_20kumar1
from Delhi, Delhi
Oct 16, 2013
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raksha tpa not approved/pass my medical bill

Address: Palwal, Haryana

Dear sir, i am requesting u that i have a policy in raksha tpa so my wife is ill so many checkup in Asian hospital faridabad then after i found according the all test report is normal but my wife is no relief after my wife admit in goyal nursing home palwal after checkup found my wife fiver /tiefied so the raksha tpa only approvd goyal nursing home bill but not approvd my asian bill so i am requesting u please approvd my bill and claimed...
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Sagar_karemore
from Mumbai, Maharashtra
Aug 30, 2013
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Medi Claim Rejected

Address: Mumbai City, Maharashtra

With respect to Member ID [protected] Policy No. 124200/48/2013/7433 allotted by Raksha TPA, I wanted to lodge the complaint that on account of hospitalization for 3 days due to infection & fever during 8 months pregnancy , Oriental Insurance/Raksha TPA has declined to re pay 14,603/- to hospital. This company have n number of reasons for refusal. However I am paying premium since 5 years to this company. In short this is a fraud company....
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Falguni raval
from Kolkata, West Bengal
Aug 13, 2013
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No mediclaim received

Address: Gujarat

My claim no is [protected] i had update all the required. Documents to raksha by mail but its sad that i did not receive any claim amount instead i was told that u hav not submitted any reqired papers. I hav all the proofs that i hav send the emails and even the documents needed for the claim now what to do further???...
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N
Neelamb
Feb 18, 2013
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no proper response for insurance claim

Address: Mumbai City, Maharashtra

Hi;


Its regarding my insurance claim That i submitted on 8Th of Feb 2013.as per told by executive i need to call wiThin week to know The status i called 25times to customer care number i.e [protected] & also marked a mail to Their official id but no proper reply received after calling so many times now They telling its not yet enrolled please help me into That wiTh whom should i contact to know The status.
br...
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A
amitt0001
Feb 25, 2012
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Decline claim amount

Address: Thane, Maharashtra

Greetings Team,

My father was admitted in hospital and got operated for "surgery of genito urinary system". First Raksha tpa approved the amount and later they had cancelled it.When I contacted them they told me submit all the documents, once patient will get discharge and we will look into this. I submitted all the documents on 28 dec 2011 and now they had rejected my claim stating that ' claim denied on ground...
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H
hemantkrk
from Delhi, Delhi
Oct 22, 2011
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Medical Bills not reimburesement

Address: Lucknow, Uttar Pradesh

Reference to our so many verbal reminders and letters still the company has not reimbuse our medical bills. We have submit all necessary documents regarding our medical claim but the company has always demanded fresh/new documents. We enclosed herewith the all documents related to our medical claim for your records and take necessary action to lodge consumer complaint against Insurance company and their TPA....
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nikhil ranjan
from Hyderabad, Telangana
Aug 17, 2011
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NOT GIVEN APPROVED CLAIM AMOUNT BY RAKSHA TPA CO

Address: Madhya Pradesh

I am the employee of SBI LIFE INSURANCE CO When i admitted to my mother in the Appolo Hospital New Delhi in the month of April 17th 2011.after confirmation of all guillines which was told by my seniors I went to Delhi for my mother treatment that time my mother was suffering from severe pain due to unknown cause as well some nurological problems jabalpur doctors could not find out the exect cause and advice to appolo hospital .After all...
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N
narendra gangan
May 27, 2011
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REGARDING MEDICLAIM

Address: Mumbai City, Maharashtra

dear sir / madam
Regarding my claim.I was been hospitalized from 15/03/2011 to 19/03/2011 at parel hospital at (parel bhoiwada) I was been affected by Pulmonary kochs. i have submitted documents whatever they needed i have pd the cash to hospital but when i have putted the documents for claim they are saying claim non payable under clause 2.3(c) at the time of admitted i was very weak & i couldnt speak to any one it...
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H
Hitesh Bhojani
from Delhi, Delhi
Mar 14, 2011
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Requesting indoor case papers Many times

Address: Surat, Gujarat

They are requesting indoor case papers from us. We have submitted original case papers and also sent photocopies many times.....

But all the times they are saying the same thing:

With reference claim <Policy no > we request you to provide the below documents to process the claim further.

1)Kindly provide the complete set of indoor case papers with history admission sheet with detail operative...
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krish_71
from Mumbai, Maharashtra
Mar 6, 2011
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POLICY NOT UPDATED & CLAIM DELAY

Address: Bangalore, Karnataka

TO THE CONCERNED AUTHORITY WHOM SO EVER :

I HAVE A MEDICAL INSURANCE SINCE 2009 WITH IFFCO TOKIO its TPA Raksha IS THE THIRD PARTY COVERING THE INSURANCE. WE HV RENEWED THE INSURANCE ON 31ST OCT 2010 & RECEIVED THE POLICY & DID NOT RECEIVE THEIR CARD TILL DATE.
BY THE TIME MY WIFE SEEMA MET WITH AN ACCIDENT IN TWO WHEELER & AFTER MRI SCAN IT WAS CONFIRMED THAT SHE HAD A LIGMENT TEAR IN RT. LEG & NEEDED...
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Hitender Gaur
from Lucknow, Uttar Pradesh
Nov 30, 2010
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Non Reimbursement of Claim

Address: North West Delhi, Delhi

I have claimed on 31/08/2010 for cash less medical at Jaipur Golden Hospital to Raksha TPA against my policy covering my 10 years old daughter Mansi Sharma having I-card No. N2108850, but they refused to provide cashless facility stating apply for reimbursement. Now I send all relivent documents with my claim of reimbursement on[protected], but after 15 dyas they again ask for the previous record including First OPD. I send all the available...
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Vijay Sood
from Gurgaon, Haryana
Nov 22, 2010
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No response to my mails for claim settlement

Address: Delhi

Raksha TPA handles my health insurance claims for Oriental Insurance Company. They neither setle my claim nor respond to my e-mails. Even the insurance company does not respond to my registered letters. Totally frustrated. Kindly advise.
Vijay Chand Sood
Mobile [protected]
mail: vijay.[protected]@gmail.com...
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Amit Dalotra
from Delhi, Delhi
Sep 17, 2010
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non payable of claim

Address: Udhampur, Jammu and Kashmir

I have medical insurance in Raksha TPA of mine & my wife under policy number 221504/48/09/41/00000898 I claim my vouchers against my insurance policy but this company refused to pay. They give reason that you will not inform us . but as per company policy when i insured is that send your claim within 15 days of from date of discharge. my claim is received on 6/07/2010 & discharge date is 22/06/2010. I understand the company that...
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Niramay
from Mumbai, Maharashtra
Jun 23, 2010
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Denial of Mediclaim

Address: Mumbai City, Maharashtra

TPA called Raksha TPA has refused a genuine claim for my mother's surgery by giving a silly technical reason that the claim needs to be submitted to them within 7 days of discharge from the hospital( our papers reached them on 8th day as per the acknowledgement though they claim to have recd. on 10th day. Their exclusion clause was never highlighted , mentioned in the small( 2''x 3'') pocket guide in a small print.I...
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aksikdar61
from Ratlam, Madhya Pradesh
Jun 20, 2010
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Non Receipt of Insurance Claim

Address: Bhopal, Madhya Pradesh

NO COMMUNICATION ON PROCESSING OF MEDICLAIM POLICY BY RAKSHA-TPA, BHOPAL
Dear Sir,

1. Details of Mediclaim Policy : Name: Abhishek Sikdar, Policy No. 152801/48/2010/186, Member ID : O[protected]MANIT

2. Abhishek Sikdar is my son and is presently studying in 4th year at MANIT Bhopal. He was seriously injured and was admitted at "People's Group Hospital in Bhopal, Tel :[protected]/4221092;...
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