insurance company declined claim

Name of Complainant Atul Rawle
Date of ComplaintApril 19, 2024
Name(s) of companies complained against
Category of complaint Insurance
Permanent link of complaint Right click to copy link
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Text of Complaint by Atul Rawle:

TPA Claim No: HI-UIC-002254113
Claim Number HI-UIC-002254113-0
Insurance Company United India Insurance Company Ltd.
Policy Number 0217002822P107448745
Corporate/Retail INDIVIDUAL
Type of Claim Reimbursement
Patient Name VIJAY RAWLE
Hospital Name TATA MEMORIAL HOSPITAL
Hospital City Mumbai
Date of Admission – Discharge 27/07/2023 – 28/07/2023
Ailment/Diagnosis CASE OF METASTATIC WELL DIFFERENTIATED GASTRIC
Claim Amount Rs.89636/-(Amount depicted is approximate. Actual total claim amount will be known post processing)

The current situation revolves around the treatment prescribed by my doctor, which I have diligently followed. As per the doctor’s instructions, I have undergone this treatment for the fourth time. It’s important to note that the previous three instances of this treatment were smoothly processed and approved by your esteemed company without any complications.
However, I was surprised and deeply disappointed to learn that my fourth claim had been rejected, citing reasons that had not been communicated to me. This sudden rejection has caused me significant distress and financial strain, especially considering that I have already settled the hospital bills out of pocket, in good faith that my insurance coverage would assist me in this matter.

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