New india assurance co
Descrepancy in passing mediclaim

I hold a mediclaim policy with The New India Assurance Company for my mother.

Name: Sudha Saraf

Mem No.: 02I00257923B

DOB / Age: 15th Sept. 1953 / 55

Policy No.: 511600/34/08/11/00003362

Period from: 31/03

Period to: 30/03

My mother was admitted in AMRI Hospital, Kolkata for a surgery (Hysterectomy - Removal of Uterus) under Dr. Pranob Dasgupta.

The total Bill for the hospitalization was Rs. 1, 37, 825/-

On submission for "cashless" claim, the total permissable claim granted by "Medicare TPA Services (I) Pvt Ltd". Kolkata was only Rs. 50, 000/-. Although the insurance cover for the above mentioned policy is Rs. 1, 50, 000/- with accumulated bonus of Rs. 50, 000/- for 1st 1 lac and Rs. 2, 500/- for next Rs. 50, 000/-

We as a family hold 3 Mediclaim Policies with your company and I or my father have been paying premium from past 14 yrs for the 3 insurance policies. We are actually surprised to learn that our first claim in last 14 yrs of paying premium deligiently has resulted in such a disappointment wherein total claim passed have been approx 1/3rd of the submitted claim. The reasons given to us by Medicare TPA is unsatisfactory and falling short on all expectations.

We are actually deliberating, whether to continue paying premium henceforth and hence request your intervention in giving us some clarity on the expectations we can have in future.

Company: New india assurance co
Country: India

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