Subject: Claim Reject on basis of 10 bed hospital
My Name: Tejas Shah
My City: Vadodara
My Complaint Against: Vipul Medcorp TPA Private Limited / The New India Assurance Company Ltd
Complaint Category: Insurance Companies
Claim Amount (Approx.): 19385
My Complaint Description:
Dear Sir/ Madam,
I have insurance Policy with New India Assurance Company Ltd having policy No. 22030034152800000452 and TPA of the same is Vipul Medcorp TPA Pvt. Ltd.
My wife Jalpa Shah was admitted in Astha Hospital, Karelibag, Vadodara from 20.07.15 to 24.07.15. I had make claim for total Rs. 19385/- to Vipul Medcorp TPA Private Ltd. on reimbursement basis on 04.08.15.
On 29.09.15, I have received letter from Vipul Medcorp TPA Private Ltd. which mention that my claim has been rejected and closed because as per Clause No. 2.14 hospital must have at least 15 beds in hospital whereas Astha Hospital have 10 beds only.
I would like to inform you that I am not aware of any such type of terms and condition and due to my wife's bed health, I decided to hospitalize her in Astha Hospital.
As all bills and reports are genuine like hospital bill, lab bill, xray-sonography bill, medical bills etc, you are requested to do needful to get justice and to get my claim money to me.
Further, just to inform you that I am paying mediclaim premium for my wife for last 9-10 years and in 9-10 years, this is the 1st claim that I have done which is rejected.
12, Arun Apartment, BOI Lane,
Subhanpura Main Road, Vadodara – 390007.