My husband undergone ayurvedic treatment at Sanjeevanam hospital at Chennai for his frozen shoulders. We applied for the mediclaim at new india assurance co in the month of February. Till today (14.11.10 i.e after 9 months of our application) our claim has not been settled. whenever we approach the insuance co, they ask something like letter from the doctor in his letter head, doctors' registration certificate & the hospital's registration certificate etc. Now they are telling, since the hospital is not registered under Form C the claim cannot be settled. Since Sanjeevanam hospital, chennai has less than 20 beds (which is required for registration as hospital under form C), they did not get registered under Form C. However it was registered under shop act. However the same insurance company has settled a patient's claim who had undergone treatment in a private hospital which was not registered under form C (this information we got from our agent). On enquiring about this, the ins.co is telling it had happened in Bhopal. And they ask us to bring a letter from the Municipal corporation of Chennai about the Form C issuance. I would like to know the following:
1. Why it took New india assurance.co. these many months (9 long months) to ask for such a detail like Form C?
2. When this insurance co. is a govt. (or semi govt) organisation and its rules should be same throughout India whereever the insured gets treatment. Is it OK if the claim settled in one state, and rejected in another for the same reason?
3. Whether we will get our claim settled?
4. Is it OK to keep the patient's claim unsettled and keeping him in dark for these many months?
5. Kindly advice & help me in getting this claim.
Thanks,
G.Vijayalakshmi.
0 comments