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Raksha Health Insurance TPA Complaints & Reviews

www.rakshatpa.com

1

Updated: Feb 29, 2024

Complaints 235

Resolved

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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Claim not settled since 40 days

Claim not settled till time

Claim put on hold due to requirement of documents

Most useful reviews

Chandigarh tpa office for not settling claim of Sandeep Kumar Jyani pf 1359119

During Hospitalization Expenses not being covered

Claim put on hold due to requirement of documents

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Reimbursement pending for long time

Rejection of my claim with out asking any query

Claim amount not passed stating bills and receipts not attached, where each and every document is submitted in hard copy

Raksha Health Insurance TPA reviews & complaints page 4

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Address: punjab national bank haripur dist araria pin 854318

I am amit ranjan. my raksha tpa member id is M58326543pnba. i had lodged a claim in last week of nobember 2021. my claim was passed on 16th of december 2021. but claim is yet to be setteled. i made complain through email as well as telephone to customer care but are they are not resolving my complain. i am completely fed up this time. kindly look into the metter and please suggest whether i should move to other channel to complain. my mobile...

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Address: chandigarh

Sir, I am bank employee and my pf no 85031, I have submitted bills/ documents as per delivered by hospital to raksha TPA, but later on mail received that some bills are not attached, than I collected the same and sent by registerd post to office raksha TPA Chandigarh, but till date no any reply and not sanctioned my claim, I have many times call to raksha TPA office Delhi and they informed me to call Chandigarh office, than I call and get...

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Address: Jhalawar

Even after query reply claim not proceed...

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Address: Chandigarh

This is to bring into your notice that I Mridula Madaan is a policy holder of PNB oriental mediclaim policy ( Policy no - 231290/48/2021/1754) from past 8 years. I have been consistent in paying my premium on time. I have a complaint regarding my hospitalization last month.

As on 24/1/2022 I was admitted to Max hospital Mohali due to severe infection in my legs. I was admited to emergency and was shifted to ICU for exceptional...

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Sir,

This is in reference to claim no. [protected]

Member ID : SBIG[protected]SBIACHD

Policy No.: [protected]-01.

Please note that this medical policy belongs to my husband Mr. Mam Chand who unfortunately passed away during treatment.
Now, I (spouse) am claiming reimbursement on behalf of him.
It's been a long time since his claim settlement is pending. I...

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Address: Faridabad

Claim number : [protected]
Member id: SBIG[protected]IITBV
The CRCM saying claim rejected due to ectopic pregnancy but it was not the case and when contacted telephonically they say different things. Everything was submitted and every document was checked multiple time. While in the last they rejected the claim on false grounds. Such fraud company don’t know they ask for paying premium if they have to reject everything...

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Address: Faridabad

I am member of raksh tpa of sbi gen insurance of retired pensioner work member is.SBIG[protected]SBIDEL and submitted bill of my wife SHARDA TARA with claim number [protected]whereas angoplasty was done by tpa mediassist of orient insurance company and adviced TMT after 6months under angoplasty but now I have only sbi gen insurance policy and no alternate to submitt bill to you which I have referred to you before test for cashless and adviced...

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Address: jaipur rajasthan

Member Id M58307991PNBA
Policy Number [protected]
Insured Name Mahesh Kumar Jajoriya
Patient Name Sonu
Relation Wife
Admission Date/ Discharge Date 15-NOV-2021 / 18-NOV-2021
For the Treatment of Spontaneous vertex delivery,
Hospital Name mittal hospital and research centre
Claim Amount Rs. 51152/-
Cheque No No Cheque Number
Approved Amount Rs.47692/-(Net Payable)br...

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Address: Vpo Katehra Fazilka Punjab

Claim number[protected]
Sir my name is Sandeep Kumar Jyani member ID M[protected]PNBA my tpa claim is of February 2021 and it's about 1 year my claim has not been settled I want to complain against tpa Chandigarh office against amandeep, shubham, Rohit and Mr Kunal Brar who is misguiding me from the last one year and has not settled my claim which is already passed. They are mentally harassing me from the last one year if my claim...

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Subject: MemberID:-SBIG[protected]SBIADEL Claim No:-[protected]

Dear Sir,
I have submitted all required documents by Speed Post on 24/12/2021 confirmation of Delivery Status screen shot attached with this mail, I have sent 4 to 5 reminder till date but your claim manager not taken any response although he has sent reminder again and again today I have received another reminder through email.
I am not understand...

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Address: Navjeevan vihar sector no-04 vindhya nagar Singrauli Madhya Pradesh

My claim is not settled by raksha health insurance tpa....

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My claim number is [protected]. Claim was passed but according to your staff statement, amount of Rs1127/- was deposited in the account which was closed? I am in contact with them for the last two years. Several times I've given the account number as demanded by them.
Amount hasn't been credited yet.
Please check and credit the amount in my account.

Neelam sikka...

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Hello- I raised my claim on Dec 18 on Raksha portal and got first and last response on Dec 24 asking to provide further documents. I did provide all the documents via e-mail to Pooja Keluskar (pooja.[protected]@rakshatpa.com) and also uploaded all docs on portal .

I asked if I need to do anything further, after that I sent 4 reminders and cc second and third escalation Mr. Darshan Surve and Amit Hegde. NO response yet. Shockingly,...

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I have done my Video MER through Raksha for LIC policy No[protected]. However the medical report submitted is incorrect Gender and inspite of many requests they have not corrected.

Due to this my LIC policy has not been revived. All costs associated needs to be brone by Raksha TPA including interest on the policy as your call centre numbers are always busy. We also tried called Manjunath ( [protected]) who handled our case from...

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My member ID is O[protected]N & sent an reimbursement claim to Raksha TPA on 3rd Nov'21 & received by them on 8th Nov'21, since that time I'm getting query letters regarding documents which I have already submitted originally via courier but again it's showing under queries which cause o[censored]n-necessary delay in claim processing. The major requirement of documents is "Disability Certificate" which I have kept original in my hand & the...

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Address: Rakesh R bank of india mariyamman koil Street kappur villupuram

Claim number [protected] and [protected]
My mother is suffering from tuberculosis (Granulomatous mastistis, consistant with tuberculosis). I have requested for the claim as mentioned above in raksha tpa, but my claim was rejected with the reason that the illness is not covered under domiliciary claim. But actually tuberculosis is mentioned in domiliciary claim. I don't know why raksha tpa rejected this. Actually my mother...

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Hi
MY mother went through Spine surgery on 14 August in Artemis Gurgaon...basis my policy i am eligible for pre and Post expenses

Since i had heard of missing bills in transit...i myself went to Faridabad office and submitted Original bills and Scans...to my surprise the receiving is done by a guard who just dumps them in an open box and doesn't give any receipt too

I have been following up with them to...

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Submitted two different admission dates claims on 14 th sept 2021 rs.36575/- and rs.32440/-settlement of the claims is pending from 2 months no ahy update from raksha or not replying the mail....

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Address: 807,cyber height,Vibhuti Khand gomti nagar, Lucknow-226010

Website: www.rakshatpa.com

My father had cataract surgery from non network hospital. I think thast the only reason for non settelment of claim because i have submitted all the original documents... and what they are continuously asking is original bill of hospital which i have already submitted.Now, I have photocopy of all original documents. They sent me 2nd reminder durig peak covid time in april, 2021...and after 15 days since not able to reply to them they repudiated...

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I am submitted all my documents on raksha app but they didnt respond properly also his app doesnt respond on documents submission thats why my submission of documents got delayed also their toll free not working also now i submitted all original documents for query number [protected] but it is closed by tpa without consulting with me. Kindly solve the issue and clear my claim amount. Thank you...

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