Mediclaim rejected by TTK healthcare services private ltd.

by Insurance India

I am SAQIB ZAKARIYA. Working with Mahindra SATYAM an IT company in Gurgaon. We have a health Insurance by the third party (TTK Health care).I have taken a ADHIP (additional health insurance programmer) for my parents and paid the premium. My parent’s policy no: ADHIP-52119349.

My mother was suffering from arthritis and was admitted in a hospital which is covered in the list of TTK health care network hospital. (Indian Spinal Injury hospital Vasant kunj New Delhi). I have submitted all the documents for reimbursement but they replied with rejection with comments” This injection therapy is not covered under their policy Terms and conditions clause 14″and moreover as per their knowledge this treatment could have been done in an OPD, however the doctors at Vasant Kunj advised that the patient should be admitted as the problem was severe and my mother was facing a hell lot of problem because of it.

As we have the insurance facility which comes under the corporate arena and is provided to us by the company, I believe that any documents and policies must have been taken into consideration before signing the contract by the employer. And to the best of my knowledge there are few diseases which are excluded that are listed in our intranet site, however the disease for which I am claiming the reimbursement is not in that Exclusion list. And after all this agony and pain the reimbursement has been rejected and I have asked TTK health care to provide me the Soft copy/hard copy of the policy where it is mentioned that this treatment doesn’t fall in the terms and conditions, but till date I have not been provided with any kind of response in this regard (be it phone or email)

I have the chain mail for this.

Here are the details:

Source: Mediclaim rejected by TTK healthcare services private ltd.