FHPL Mediclaim/ICICI Lombard
General Surgeon Charges deducted from my Medical Claim

This complain is regarding one of my recent claims from FHPL Medicalim. FHPL in the backend has tied up with ICICI Lombard.

The calim was a C Section operation for baby delivery and this was a Cash Transaction since the hospital was not listed as part of Cash less transaction.

The Amount which I had claimed for was Rs 22, 398 and the amount reimbursed was 18041.00. The charges that were not re-imbursed were Rs 4000.00 which is General Surgeon Charges. I am surprised on how an operation can be done with out a surgeon?

Now how would they have dealt with Cash Less Transaction. Does that mean there is some under hand relation ship with the hospitals and the insurance team?

I think the cash based transaction is unfavorable and I am facing this for the second time where in good amount of money is not cleared and each time with vague reasons.

Kindly help me on how I could go about this.

Rgds

SREEVATSA