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Raksha Health Insurance TPA Complaints & Reviews

www.rakshatpa.com
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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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Most useful reviews

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 6

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V
vasantpatel32211
Jun 29, 2021
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Deduction in the claim for the Policy Number 21020934202700000010 / under Claim no- 90242021455615

Dear Sir/Madam,

This mail is in regard to the Unfair Insurance Payment or Settlement for my details mentioned below.

Name of Insurer: VASANTBHAI VIRJIBHAI PATEL
Policy/ Claim No: - Policy Number[protected] / under Claim no- [protected]
Claim Amount: - Rs. 143450.00
Sanctioned Amount: - Rs. 99110/-

Please find our submission on your settlement description: -br...
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A
ashok kumar goel1
Jun 20, 2021
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NOT RESPONDING AGAINST Claim intimation of policy no. 252400 / 48 /2021/630 DT 25.01.2021

Address: 12 A BEGUM BAGH TILAK ROAD meerut u.p. 250002

DEAR SIR/MADAM,
I AM CONTINUOUSLY FOLLOWUP REGARDING MY Claim intimation of policy no. 252400 / 48 /2021/630 DT 25.01.2021
BUT NO RESPONCE UR SIDE REMINDER1, 2 MANY MAIL SEND BUT NO ANSWER I CALLED TO RAKSHA OFFICE AFTER PICKUP ONE OR TWO DETAILS CALL DISCONNECTED.

IN FUTURE IAM NOT SUBSCRIBE WITH RAKSHA POLICY

all doctors releaving documents discharge card couriered through speed post dt 07.04.2021...
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K
khushboo.gautam
Jun 18, 2021
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Unacceptable deductions in claim

Address: Lucknow
Website: crcm@rakshatpa.com

Since 3 months I am contacting their staff for deductions in my claim but no justified answer has been given.my only concern is that when same hospital bills has been passed by them in second claim then why they have deducted amount of the same hospital bills in first claim.when I asked one of their staff then he threatened me that he will reject the second claim also which has been passed already.
No one answer my question and also...
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A
Agarwalvk
Jun 15, 2021
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Non compliance of my request

Address: Chandigarh

I need Item wise details of deduction from Hospital Final Bill, which are not provided despite my repeated requests....
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R
Raj@2345
Jun 14, 2021
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Reprocess of the case

As I've been writing continuously but no response is coming back.
I request you again to reprocess my claim.
number [protected] for Raj Kumar Rai
I have even submitted my documents multiple times, all of the documents that were asked for.
Please look into the matter ASAP...
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A
Agarwalvk
Jun 10, 2021
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Mediclaim Bill Settlement

Address: Chandigarh.

Given below are 2 Screenshots of Claim Settlement Letters of Raksha TPA for Oriental Insurance Co, and of HDFC Ergo for your reference and records.
There is a Very Important Difference between the two, as the Instructions for Amount Deducted from the Hospital Final Bill, to be Paid by the Patient or Not.
While Raksha TPA has Clearly asked the Insured to Pay all the Deductions, HDFC Ergo has asked the Hospital Not to Charge it...
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K
khushboo.gautam
Jun 6, 2021
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Misbehave by staff

Address: Lucknow

I have contacted many times to raksha tpa office regarding deductions in one of my claim but didn't get satisfactory answer also recently one of staff talked very rudely and also threatened me that he can also reject other claim which has been passed by the company.
Very rude behavior and very unsupported staff....
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A
amituptu2012@gmail.com
Jun 2, 2021
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During Hospitalization Expenses not being covered

Have submitted the claim with bills to the Raksha TPA Office on 18th of March but there is no update yet from them
Today I just had a call with Customer Care and from there I got to know that claim was denied because pre and post hospitalization cover is not there.
In claim there was 10422 INR during hospitalization because some medicine was not there in hospital and I bought myself from hospital TPA I was told that you can...
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M
madhunaveena
May 28, 2021
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Claim rate very low

Address: Mumbai
Website: www.rakshatpa.cim

Claim rate is very low.beacuse of this reason I loss 20000rupees from my side.
This health insurance company not accepting total bills because of this reason I loss 20000rupees.hospitals total amount collected from side.that total bills not claimed by this health insurance company.please take action...
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N
neeleshame
May 20, 2021
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Reimbursement claim not processed

My raksha TPA member ID is O[protected]JETAIR and claim no. is [protected]. About 15 days have been passed past filling of reimbursement claim but the claim is still in 'processing' stage. Please look into the matter to settle the claim at the earliest....
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D
DeepMittal
May 15, 2021
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Claim approval

My father ( Mr Suresh Kumar Mittal) and mother (Mrs Madhu Mittal) were admitted in Maharaja Agrasen Hospital Dwarka on 14/4/21 as they were covid +.
Unfortunately, my mother and father got expired on 1/5/21 & 3/5/21 respectively.
The total hospital bill of Rs. 10, 00, 000 + (bill attached). The person who looks after Tpa claim in hospital said that my parents claim file has been mailed to Raksha Tpa and Rakha Tpa is neither...
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S
Sandeepfloret
May 10, 2021
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Chandigarh tpa office for not settling claim of Sandeep Kumar Jyani pf 1359119

Dear Sir/Madam,

Respected sir/Madam,

My name is Sandeep Kumar Jyani pf 1359116 working at b/o Arniwala sol 030110. Sir last year in November my 3 years old son fell sick and hospitalised then my son admitted in delhi child care hospital sriganganagar rajasthan from 21 to 24 November 2020 then dr told us for meckel's diverticulum test then we went to SDMH hospital jaipur where we tested him meckel's diverticulum...
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A
Amit_Kapoor
from Gurgaon, Haryana
Apr 9, 2021
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Claim not pass

I raise a complaint on 05 April 2021 regarding claim not pass till date and said complaint is closed says that complaint is resolved
There is no response about the complaint, then how said complaint was close without resolving it...
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A
apurvadh
Apr 9, 2021
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Rejection of claim

Address: Mumbai

Claim no. ([protected]); Member Id: UIC[protected].
My above claim is more than 1 yr old. I hd initially lodged claim with M/s Star Healthcare on agents advice, but due to sub limit being exhausted my claim was rejected and original documents were returned. Raksha tpa RM has refused to pass my claim alleging that my claim amount has been paid in part by Star Health despite my giving them claim amount disbursement certificate stating...
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A
Amit_Kapoor
from Gurgaon, Haryana
Apr 5, 2021
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Claim not pass

I raise a claim vide claim id [protected] and also send reply of query dated 07 dec 2020 within 15 days i.e. on 20 dec 2020 but your company rejected my claim without any intimation
Please do the needful...
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P
Pushpagarg
Mar 25, 2021
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Claim passed but amount not given

Name sunder pal garg claim amount rs.41398 claim no.[protected]...
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N
Norton O\' Brien
Mar 21, 2021
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No update for 10 hours

My wife is admitted for hernia surgery and has been requested to discharge today. From afternoon we have been trying to reach via email and phone to get the claim approval and there has been no proper response from Raksha TPA.

I have a 7 months old kid as well and my wife is getting mentally stresses because of this situation, as we need to stay one more day due to lack of response from the so called 24/7 team.

During...
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Y
Yogesh kumar rani
from Jammu, Jammu and Kashmir
Mar 19, 2021
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Non settlement of claim recommended for non pay

Address: Ra

Sir I submitted claim of my wife right tube raptured claim no.[protected] I submitted all documents provided my Hospital but after continuing giving reply my claim recommended for non pay...
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S
sangeetadevi
Mar 18, 2021
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Non settlement of claim no 9041920725264 dt 09 jan 2020 member ID N90227702LICGKP

Address: LIC OF INDIA BO 2 GORAKHPUR UP.

Sir I have submit my daughter tuberculosis treatment claim ref no.[protected] dt. 09.01.2020 and my member ID N90227702LICGKP. I am employee of LIC OF INDIA BO-2 GORAKHPUR UP. I had sent all query document for ct thorax and suporting investigation dt 05.11.2019 by our office latter dt.15.12.2020 and mail 25.02.2021. Kindly look into the matter and resolve my issue and early settelment of my claim.

Thanking and regardbr...
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A
Amitnarayan Pandey
Mar 17, 2021
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Delay in claim settlement claim no.90432021642525

Address: Vibhuti khand ,gomti nagar ,lucknow

Respected sir
Whoeith regards kindly i inform you that my claim no [protected] has been taking longer than usually.inspite of i submited all related document as per query raised.but it seems there is no carefully attention about my claim settlement no information is updating about claim status.
Plz acknowledge the same
I will be thankful to you...
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