To,
The Divisional Manager
The New India Assurance Company Ltd.
Mumbai
Ref: Policy No: 131000/48/06/20/70003928
Claim Ref No. 11629820708
Dear Sir,
I have submitted all the documents regarding the claim for Fungal Sinusitis to the RAKSHA TPA 5 months back. They haven’t processed my claim yet.
They asked for the DNS surgery, details that had been done 5 year back. I have given the doctor’s certificate stating that Past surgery has no relation to the present Fungal Sinusitis surgery.
I have taken my Medical Claim policy from the year of renewed continuously without any break and not yet claimed for this purpose. I also submitted the proof for the same.
Still, my RAKSHA TPA is still closing my claim; I don’t have any choice and will take the legal action in Consumer Court with my valid following points.
1. My policy was valid from the year 2000 continuously with out any break
2. I have submitted doctor certificate claiming that Fungal Sinusitis has not relation with previous DNS surgery done more that 5 year back.
3. Fungal Sinusitis and DNS Surgery are different, Why do they need the DNS Surgery Details that has been done 5 year back?
4. I haven’t seen anywhere in the rule of “The New INDIA Assurance Company Ltd.” to keep the 5 year back surgery details that is not related to the present alignment. In case it required, I have lost it while shifting.
5. I never claimed for this purpose.
Regards,
--Ashish Varghese
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