Feb 06, 2012 05:29 PM
20543 Views
I am covered under corporate group policy and had my mother admitted to hospital for one day since her fever was not subsiding and was on and off for 15 days. Initially diagnosed with some traces of typhoid our local doctor started medication for typhoid, but after the fever would not go away, she prescribed my mother to get admitted.
In the hospital, doctors prescribed tests and treatment for malaria/typhoid and my mother was kept on observation. The tests did not yield positive for malaria/typhoid, so she was discharged.
On making the claim, I got a rejection from TTK under clause:
4.10: Expenses incurred at Hospital or Nursing Home primarily for evaluation / diagnostic purposes which is not followed by active treatment for the ailment during the hospitalized period. This was not in agreement and I wrote them a mail refuting this. They gave me a TTK CRM # and were supposed to reply back to me in 7 days, but even after 10 days, they did not reply. Calling them was even worse, as everytime their systems were down. I finally managed to get one executive on line and asked him if they can send back my documents. I was surprised to hear that they do not send the medical bills back but only a scanned copy.
Could not make out anything of this, because in case they have rejected the claim and not paying a single paisa, then why not send the original documents with the bills back. Wonder what do they do with the biils? These guys are cheats and I think their policies are written in a way to avoid paying the customtakeouters and harass them in every possible way. I will strongly advocate everyone to reconsider TTK as their TPA, because these ppl are professional CONS I will like to fight this case with them, if it means spending more than what I have claimed. Can anyone point me in the right direction. My mail id is harisingh.rajput@gmail.com
