I am a dialyses patient & got dialyses from Aakash Hospital Dwarka New Delhi. I have a Mediclaim Policy I want to know what is TPA sign MOU with the hospital they charge extra for Diliser & it's tubing but TPA said that it was included in policy how I come to know is it's included or not They are charging extra can you help me out with this problem Regards Ashok Gulati more
IF THERE IS ANY GRIEVANCE THEN THE SAME SHOULD BE TAKEN UP WITH INSURANCE COMPANY.TPA WILL ONLY SETTLE CLAIM AS PER POLICY CONDITIONS.MANY TIMES AGENTS DO NOT DISCLOSE RIDERS/EXCLUSIONS WHILE SELLING POLICY AND THE CONSUMER ALSO DOES NOT ENQUIRE ABOUT THE SAME,WHICH RESULTS IN UNNECESSARY GRIEVANCE. PLEASE READ POLICY CAREFULLY AND THEN TAKE UP WITH YOUR INSURANCE COMPANY. . more
As far as my knowledge goes, GIPSA rates fixed for various hospitalisation expenses which has been arrived at between TPAs/Insurers and the hospitals. With respect to coverage, normally hospital explains to patients on this so that they are not in lurch once they leave hospitals. Again I noticed in the country that inspite of this agreement, sometimes, hospitals delay the discharge of patients on the pretext of acceptance of the bills by the TPAs which is unwarranted. I opine, government must set clear cut rules and regulations in this respect. more
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By Padmanabhan G
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