while opting these mediclaim policies, these seems very good, but while required these becomoes headche, I was hospitalized and applied for cashless facility but TPA denied and recommend for processing the claim after discharge. Doctors faxed lot of papers but TPA did not approved the cashless, and fianlly we had to pay the money to hospital. Can some one suggest me what could be done in these cases?
Be careful while taking mediclaim policy, as all company has tie up with TPA for claim processing and as the claim goes to them they start saying this is not included in policy, this can not be given to u,this is not possible,we cant help u,insurance co cant do any thing.Being worked for insurance company, my inner voice forced to opt out of this industy as this is the sector where sales guys are put under great pressure to work and bring business hence they all take a path of crook or hook. Dont ever belive sales guys wat they says plss read the document carefully... Plss plsss read it carefully.Pls follow these point whie taking policy any policy 1: Read it carefully 2:Fill the complete form on ur own 3:Plss give all document required for policy , if you dont give the document are forgged.
I dont think Health Insurance Industry has grown to Rs.8000 croes worth due to true service. It is mainly due to growth of corporate companies and IT exemption tag.
I AM MARRIED RECENTLY I HAD MY MEDICLAIM POLICY OF UNITED INDIA, I WANT TO ADD MY WIFES NAME ALONG WITH MY POLICY, SHALL THIS POLICY COVER THE MATERNITY CLAIM IF SO IN THE CURRENT YEAR
All above said answers looks good before you take policy. Once you take up policy trouble starts as agents are see no where. Policy holder suffers at the hands of insurance company and TPA.
Re: Fooling
by PRABIR DE on Jun 29, 2010 06:03 PM
Yes I Agree with manoj , not only that the hospital and nurshing homes are generates excessive bills when they knows after patients mediclaim package or policy.
Re: Re: Fooling
by RathaChamundeeswari Angalamman on Jun 29, 2010 07:13 PM
yeah. We SHUD be doubly careful if it comes to claims. TPAs conveniently ignore or they nit pick one way or the other. Most of us are not lawyers to go line by line. Caveat Emptor
Re: Re: Fooling
by Debashis Shome on Jun 29, 2010 08:00 PM
WELL ITS A NAKED TRUTH WHAT BOTH MR PRABIR DE,MRR.C.ANGALAMMAN HAD DISCLOSED.WHERE LIES THE SOLUTION, MAY A MORE HUMBLE AND HUMATERIAN APPROACH FROM THE INSURED CO AND THE MOST DIFFCULT PART IE THE THE TPA COMPANYS.MORE CLARITY IS NEEDED IN FRAMING THE DRAFTING THE PROSPECTOS WITH NO HIDDEN CLAUSE.DEBASHIS SHOME.
