Health Insurance Unjustified Reimbursement Claim

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Tamil2989

New member
Policy Name
NEW HEALTH INSURANCE SCHEME - 2022
Company Name
UNITED INDIA INSURANCE CO. LTD
Customer Care Number
18002335544
Loss Amount
518245
Ratings
2.00 star(s)
Opposite Party Address
United India Insurance Company Ltd,
Divisional Office,
6 PLA Rathna Towers,
5th Floor, 212 Anna Salai,
Chennai - 600 006.
Sir/Madam,
This is Nanjappan. N, aged 75 Medical card Number CBETNHISP22R02404656 government pensioner I had undergone Cardiac bypass surgery and valve replacement on 12.10.2023. The total cost was 749595.We went for reimbursement under New Health Insurance Scheme - 2022 through United India Insurance Co. Ltd. After many number of enquiries one year later we received the claim of amount 231300 which was unacceptable. We enquired the insurance agency also. So, kindly do the needful for the total amount.
 
Dear Mr. Nanjappan,

We understand your concern regarding the reimbursement under the New Health Insurance Scheme - 2022 by United India Insurance Co. Ltd. Given the discrepancy between the total medical expenses incurred (₹7,49,595) and the reimbursed amount (₹2,31,300), we recommend the following steps:

  1. Review Policy Terms: We strongly suggest you to examine the policy document to understand the coverage limits, exclusions, and reimbursement criteria. If you already examine and not found any reason, please share the PDF.
  2. Formal Grievance: If you have not submit a detailed grievance to United India Insurance's Grievance Redressal Officer, we recommend you to escalate the issue with them via E-MAIL or REGISTERED POST, including all relevant documents and a clear explanation of your concerns, ask them the detailed explanation with 15 days.
  3. Escalation: If you have not received any response or unsatisfied with the response, you can file a case in the Consumer Forum to get justice.
The above steps are very helpful if you file a case in the Consumer Forum. Their are thousands of cases filed against the United India Insurance.

To view case visit : United India Insurance Customer Care Complaints | Consumer Court.

For any professional legal assistance, please contact us.

Thanks
 
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