Sub:TTK authorized letter and amount has been withdrawn without any specific reason after the surgical process


I am an employee . Few month backs (2months), i faced some nasal problems , for which i had consulted Manipalhospital for a check up as it was closer to my office. After undergoing few diagnostic tests , they have identified it as "B/L Sinonasal Polyposis With Pan Sinus".


My Dr recommended to resolve this problem through a surgery called Endoscopic Fronte ethmoidectateral Surgery (surgical removal ) and suggested to do the operation at the earliest. .

Based on this, I had send a pre-authorization request through Manipal Hospital after consultation with the ENT Department for getting Insurance Approval on 19-Jun-2010 from TTK. As I received the approval on 20-June-2010 for Rs.20000 from TTK through SMS and the hospital received the same via fax. Hence I decided to get the further treatment at Manipal itself, else I was planning to get the surgery done in my native.

Based on these, I got myself admitted for surgery on 24-Jun-2010 and i availed myself the cashless facility.

The surgery happened on 25-June-2010 and when i was about to be discharged from the hospital on the next day, i was told to pay-up Rs.32,517 from my pocket as TTK had withdrawn the earlier approval they had sent which put me off both mentally and financially.

The reason for denial as per TTK was due to a 2 year exclusion as per policy terms and conditions and hence cashless access was denied.

I would like to know why a sum was approved without checking the policy terms and conditions, there negligence is making me suffer financially, else I would have planned it in a better way. .If I had been properly intimated about this i would have opted for a surgery in my native place at the fraction of cost, that too at a later date . I suspect a foul play and feel cheated and robbed by two institutions.

Because of all this I had to avail a lone which has to be repaid now. Kindly look into this and get the back to me .

I under went Nureosurgery for oligodendro glioma grad ii in appolo hospitals where a claim was settled for Rs.2 lakhs and odd for the surgery also i under went radiotherapy in the same hospital. I submitted my claim for 1.82 lakhs on 27/12/2010 until now i have not received any reimbursement or any reply for my mail. I have to undergo MRI this month every time when contacted their mumbai office they give a standard reply it is still in processing stage. It is almost four months still not settled. Please help.

Hi,
I had a similar experience. We had this policy through my college NITC.I wanted to avail cashback policy for my treatment in January at a hospital not under their scheme(as that is also supposed to be reimbursed) . I had sent them all the claim receipts, doctors letter ,but they did not respond. Calling to their call center has been futile too. I have eventually given up the fight to claim 13k which they owe me. But i request everybody to not take this insurance.
Contact email: sukritiii@gmail.com