I take a insurance last 10 years in insurance company but they do not pay a claim amount last year in 2010 11 claim number in e-meditek tpa is 903654 i add all detail bellow.
Regional Office (ahmedabad) Sakar-5, 7th Floor, 709, Behind Natraj Cinema, Near Gandhigram, Railway Station,
Ahmedabad - 380009, Gujarat
Phone No : 079-40215777-80, Fax No : 079-40215771-72,
EMail: [email protected]
REPUDIATION LETTER
WITHOUT PREJUDICE
Date: Jan 25
The Oriental Insurance Company Limited
Relief Market, Near Vepari Gin,
Kalol - 382721,
Gujarat
Sir / Madam,
Reg:
Hospitalization claim of: Shardaben K Patel
Employee Name: Kanubhai C Patel
Employee Number : - Na -
Hospitalization Period: Dec 20 - Dec 25
Hospitalization At: Devasya Hospital
Diagnosis: Adpkd End Stage Renal Disease
Our reference No: OI/INDO/100903654
Policy Number : 143601/48/3602
Repudiation Letter No. : EMSL/REJ/100108719
We are in receipt of the claim form & associated documents of Shardaben K Patel. On scrutiny of the same, we observe that he / she was admitted in Devasya Hospital. patient was admitted with c/o dyspnoea, pedal oedema and bilateral renal crepittation. DX as ADPKD END STAGE RENAL DISEASE patient was operated for left radiocephalic fistula at wrist at nail hospital. hemodialysis done in devasya hospital. ADPKD [Autosomal Dominant Polycystic Kidney Disease] is genetic disease so this claim is not payable as CLAUSE 4.15 Genetical disorders and stem cell implantation / surgery..
In view of the above, we are left with no option but to repudiate your claim.
We regret the inconvenience caused and view this as an opportunity lost to be of service to you.
Yours Sincerely,
For E-Meditek (TPA) Services Limited
Dr. Hitesh Patel
CC :
1.
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