My father underwent coronary angioplasty on an emergency basis, and he was ready for discharge in two days. However, the claim procedure for cashless was inordinately delayed for more than 72 hours, as Raksha TPA Private Limited who was the third party handling my father's claim for oriental insurance company had no records with it of any of his policy details from his past. And Raksha instead wanted to back our claim with all the policy copies SINCE INCEPTION, along with documents of ALL THE OPD CONSULTATIONS AND MEDICAL TREATMENTS. My father being 78 year old and the policy being in force since decades we could not avail all those policy copies. And since he had no illness prior he was not on any long term medications, ever which was communicated to the office. And the processing team at Raksha said, since Raksha TPA had no information with it of past polcies, even if we submitted those copies it could not have cross verifed those for many days, until they got official copies from oriental insurance office. As a result of which my father who was otherwise medically fit for discharge overstayed in his suite in the hospital for three days, incurring additional bills. On contacting the coordinator, Mr. Harish [09739998767; 9739998767] from Bangalore, he declined to offer any intervention, who just said that he was with his wife, and wished not to bee bothered. In my professional life, I have never come across such a shallow excuse. And Mr. Harish refused to address this issue three days in a row while in office or otherwise. And I cant help but worry about him and his family's healthy, considering that he was busy for so long - I just pray for his family. Considering that across India hospitals are running so short of beds due to dengue an such illnesses, I am sure Insurance companies should be doing their bit by processing claims in a timely and professional manner. And any excuse will only worsen the situation for people wanting admission but lacking beds.
Complaint Category: Insurance Complaints in New Delhi, Delhi