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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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5
Chandigarh tpa office for not settling claim of Sandeep Kumar Jyani pf 1359119
4
During Hospitalization Expenses not being covered
3
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 5

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D
damini saxena
from Gwalior, Madhya Pradesh
Oct 8, 2021
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Claim problem

Address: raksha plan

My claim date is 06/08/2021 August and
there was not settled my claim .
i suffered more difficulties in claim process
its to be bad raksha plan.
i m facing more problems in raksha plans....
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N
Naman129
Oct 1, 2021
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556222122258141 - Claim not processed more than 70 days days completed after registration

Address: Vill+post-kaland, Sadhana (Meerut)
Website: Raksha TPA

Please provide me breakup detail of my claim - [protected]. I don't know why so much time consuming either company commits max 50-60 days for any claim processing. Before 50 days Raksha TPA commits same status i.e., Claim is under investigation. Please share details breakup & reimburse my claim as much as earlier....
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P
PNB Rahul Singh
from Saharanpur, Uttar Pradesh
Sep 21, 2021
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Claim passed but payment not received

Dear sir/madam
I have registered a claim with member id M58341591PNBA and claim has been passed 25 days ago but till now i have not received my payment.

Claim Number : [protected]
Insured Name: Hema Rani
Hopital Name: Smriti Nursing Home
DOA : 17-AUG-2021
DOD : 19-AUG-2021

Please do needful as soon as possible. I'll be thankful to you....
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Shravanan T
from Coimbatore, Tamil Nadu
Sep 8, 2021
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Raksha Health Insurance TPA Claim not settled yet

Address: Raksha Health Insurance Pvt Ltd, Stellar Sphinx, 4th floor, Above Himalaya Book World, Banjara Hills, Modhi Nagar, Dwarkapuri, Hyderabad 500034

I, Saravanan T, was admitted to KR Hospital on May 9, 2021. As an employee of Imedx, for reimbursement, I have sent all the required original documents to Raksha TPA, Hydrabad through ST courier on June 10, 2021 and the documents were delivered on June 16, 2021, but still they are asking the same documents. It shows that they are not willing to settle the amount. Please take the necessary action to immediately settle down the claim....
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S
suchipara
Sep 6, 2021
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Claim not settled yet

Address: mumbai 400036

My claim no is [protected]. I Dr. Priti Trivedi had been operated 21st May 2021. all original document sent to your Andheri office by courier for reimbursement processing. all query's solved from my end but still case is not re-open from your side can you please cross check & reopen this file ASAP....
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R
Rupaina
Sep 5, 2021
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Harassment

My new born baby was adimitted in Jaswal children hospital on dated 13/05/2021.and discharge from hospital 26/05/2021.my member id is M58339777pnba .my baby is hospitisation since 23/06/21 .I sent theclaim document on dated 29/06/21.by speed post. But Raksha tpa mark objection of late submission of claim document. I attached the post hospitalisation bill. Till 23/06/2021.fifteen Day time for submission of claim document. Why tpa demanded...
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S
sahuankit2010
Sep 2, 2021
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Reg : Claim no 58432021435301

Sir/ madam,
With reference to subject, this is to inform you that myself ankit kumar sahu P. F. 0316709 and Membership ID is M58316709PNBA lodged a online claim in oct 2020 with claim no [protected], the claim was passed in April 2021and then I had sent all the original document via registered post on 26 th April 2021, and still after 4 month passed the claim is not settled yet.
Kindly resolve the matter....
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N
nikunjmittal1
Sep 2, 2021
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Not passing the simple claim after providing the all details many a time

Address: 65/17 panchsheel colony, Garh Road Meerut

Dear Team,

We have applied for a PNB health insurance settlement claim [Claim no. [protected] ] on 1-Jun-21 with Raksha TPA through mail and email to Raksha TPA Faridabad office but every time, they are asking one another documents.
We have also told if you find any discrepancy in any particular bill, pls remove it from the claim list but every one of their reply comes after 10 days and then they ask same details...
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K
KRISHNA VAID
Aug 31, 2021
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Regarding claim not fulfilled due to bank mistake

I have registered my policy in 2016. Due to some reasons, I missed one policy premium which results in gap in my policy. And bank claimed me that they will recover the gap of the policy and continue my policy from the 2016 . So then I undergoes my policy on march 2020. And In july 2021 I went for cataract operation. As I was not aware about any policy details. And I registered the claim through oriental office. And now my claim got cancelled...
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R
Raju Sen Gupta
Aug 24, 2021
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Niramaya Status of Rishi Sen Gupta is not updated

Dear Sir/ Madam.

I beg to state that my son's policy no. 214600/48/2022/367-005 & Health Id no. O[protected]N on period date[protected], But online showing is Invalid, Niramaya Status of Rishi Sen Gupta is not updated....
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G
gursant
Aug 24, 2021
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Claim not processed,query replied

I have submitted the claim wide [protected] & all queries replied.But claim not processed and also no reason shows.
Plz process or give the reason of non pay.
Gursant Singh
[protected]...
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M
Mani Pabbi Bhardwaj
Aug 20, 2021
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Senior citizen cashless approval not received timely

SBIG[protected]SBIDELTP- urgent - clearance not done

It's always been the same story.Since morning we waited for approval from Raksha TPA and till late evening we are waiting....
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M
manish.saini
from Chandigarh, Chandigarh
Aug 10, 2021
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Pathetic Customer Care of Raksha TPA

Ref No. : [protected]/24
Dated : 14.06.2021
Member ID : O[protected]

I am regularly sending mails to Raksha TPA, not a single respond coming from there side
Why they guys are recommending for Non Pay
I lost my father during Covid Wave 2, we submitted each n every genuine documents
They guys are not giving proper & genuine reason...
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R
Rajeeva61
Aug 3, 2021
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Claim

Address: Lucknow

My wife has suffered from covid 19 due to which oxygen level come very down because of which I admitted my wife at abha nursing home Kanpur where I got a bed and I file a claim on May 21 but I do not get a claim. now they are refusing to give claim saying that patient has past thriod I am taking Mediclaim policy since 2011 and my wife has throid in 2016 how they can refuse the caim on this ground please check otherwise I have to fight in...
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I
iris hospital
Jul 21, 2021
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regarding payment still pending of patient name - hiteshkumar patel claim no-545222021547795

Address: Lambhvel Road

Hello Team Raksha,

This Reminder for cashless settlement payment of patient name-Patient Name - HITESHKUMAR PATEL Claim no-[protected] was discharge on Month of Dec-2020 but Patient payment not settled in our Accounting so please provided settlement letter or UTR no.

Please feel free to revert for any future query....
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R
Rishabh Garewal
Jul 15, 2021
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Regarding my claim settlement

Address: Indore

I have deposited my hospital hard copy at your indore branch on 31 May 2021 But till now they have not uploaded the file to the portal. Because of that claim in unsettled till now.
Member I'd M58345076PNBA...
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R
Rajiv_C
Jul 8, 2021
Resolved
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Claim put on hold due to requirement of documents

Address: Faridabad, Haryana

Claim no: [protected]
My mother, Savita Chopra, MemberID: SBIG[protected]SBIDEL
Policy No:[protected]-01, was admitted to Fortis Hospital Shalimar bagh on 28th May - 30th May and had to get angioplasty done.

This was supposed to be a cashless experience but Fortis informed us that the contract with raksha TPA has expired and the amount needs to be paid entirely by us. We had no intimation from Raksha TPA...
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T
Tusharkashyap
Jul 5, 2021
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Not getting my approved amount from last month

Member ID SBIG[protected]SBIACHD
I filed one claim and for the last two weeks, this is approved but not getting the amount in my account. Whenever I do a discussion on this executive says that you will get the amount in one or two days and I am listening this from last two weeks.

I need the amount because I have to clear my debts and to be honest other companies like ICICI and others will not take such a long time in...
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V
vineet1811
Jul 3, 2021
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Claim Repudiated

Address: Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai -01

My compliant was repudiated only on the ground of non admission for 24 hours. Juts to inform you that I fell prey to Covid 19 and during my Covid treatment, I was denied hospitalization by the hospitals due to non-availability of beds in the hospitals and therefore, all necessary arrangements with regard to patient care/treatment were made at home along with drips, injections, medicines and glucose which was made available by a nearby clinic...
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G
Gurmit@1951
Jun 30, 2021
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Non updating of Bank details for claim 55652122103031

Address: E-61,Ranjit Avenue Amritsar

I have uploaded bank details for reimbursement of subject claim. As per information given by customer care details are still awaited. I have also sent details at email [protected]@rakshatpa.com, , finance.[protected]@ralsha.com&[protected]@rakshatpa.com as advised by Customer Care but still status shows bank details awaited.
Kindly look into it and expedite my reimbursement....
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