Complaint Rating:

I am a software engineer and working for Samsung company based in Noida (NCR region) and each year all employees have been given Mediclaim policy for all.So for the period 01-Jan-2006 to 31-Dec-2006 our company has tied up with Raksha TPA Pvt Ltd, under the terms that if any employee who will be admitted in the hospital for at least 24 hrs can claim the money from the insurance company.

Now this happens on 21st Oct-2006 (Diwali eve) that I was accidentally got burnt (1/2 degree) on my right hand side and i was in the hospital till 02nd nov-2007. When I was in the hospital I contacted my company HR people for the cashless treatment and they have given me the contact number of the concerned person Mr. Deepanshu (9810924486) who is the representative of the insurance company Raksha TPA Pvt Ltd.When I spoke to Deepanshu during my 3-4 day in the hospital then he said you please fax us the estimation cost and we will approve it. I did the same but didn't get any response. When I again called him he said there is some problem in the approval, you do one thing make the payment by yourself and later claim it after you get discharged from the hospital.When I discharge from the hospital I submitted my all the bills in original to my company which in turn forward the papers to the insurance company in January, 2007.

In march 2007 I got a query letter saying I didnot submitted some documents and insurance company need those ones. Again I tool all the documents from the hospital and couriered them on 15th March which has been received on 16th march 2007 (please attach the proof for same). After 2-3 weeks when I inquired about my status then they said they haven't received my papers/reply. I again send them the same papers. Now when I inquired again about my status in July 2007 they said they haven't received my papers.
I think they are unnecessary creating the delay and don't want to reimburse my money.

The address of the insurance company Raksha TPA Pvt Ltd is :-

Corporate Office 15/5,
Mathura Road, Faridabad,
Haryana-121003.
tel No 0129-2250000/01/5043059
fax 0129-2250002
E-mail rakshatpa@escolife.com.

During my communication I communicated with the following people from the insurance company.

1. Mr. Deepanshu 9810924486 (This is the person who is interacting with our company for insurances to be claimed).
2. Dr. Vidhi 9818623481 (She is the doctor who claim/pass/examine the medical bills)
3. Mr. Asif 9818220055 (This is also one of the representative of the insurance company).
4. Customer care number 95129225000.

But all are in VAIN...

Best Regards
Bharat Kumar nayyar
Mobile 9871553999
Noida