By | January 15, 2013

MY husband works in COGNIZANT TECHNOLOGY SOLUTION PVT. LTD. emp id- 305396 and covered in family group insurance from UNITED HEALTH CARE PAREKH TPA PVT. LTD by the company unfortunately my son yatharth vashisth was first diagnosis with inguinal hernia on 2/5/12 in apollo hospital, noida where he was born on 12 october 2010 then doctor Arvind Garg of Apollo Noida same was at his birth on apollo recommended us to dr. sujit chowdhery,apollo hospital,delhi and he communicated me we need surgery to repair hernia then first thing i did that confirmed with the bill dest of noida apollo does it covered in insurance as surgery should be done their and after their assurance my child was admitted on 9/5/12 to apollo hospital,noida for surgery and operated on 10/05/12 by Mr. Sujit in apollo noida and I gave an application for cashless hospitalization to united healthcare pvt. ltd.on 9.5.12 with required documents through bill desk of apollo Hospital, Noida. on 10 .5.12 first they have sent the query to hospital in the afternoon is this a congenital hernia? then dr. sudha and dr. arvind garg Pediatrician replied in writing at apollo letterhead this is not congenital and this was an indirect inguinal hernia and they asked me for the birth discharge summary which I did not have and I am sure that there was not any complication on his birth to him infact i think apollo hospital can arrange his summary from his records because he was born on same hospital thatswhy i preferred that hospital for the surgery in mean between my husband who was in pune office talked to representative many times and they assured him that yes sir we are doing and infect told him that it has been approved and he called me to saying that it i s done but when i went to bill desk they said they are waiting for the reply and after waiting so many hours at 9:23 p.m they sent the denial for cashless admittance mail to respective department of apollo noida.My complain is that why we are giving the premium if we are not covered ,and when apollo hospital gave the answer of their query then how they can reject the claim on he same ground,why they were giving wrong information to us and beside that if it is not covered clear it in starting they took so much time for denial i donot go the apollo and do not admit 2 days there i paid the cash at 11 on the counter otherwise i pay more for the night it was so risky and insecure to me to go ghaziabad with my baby in midnight and most interesting My husband cannot give the bills for mediclaim to company because of hospitilazation i have paid Rs. 37372 from my pocket and cannot show the bill for mediclaim rebate . I required compensation atleast of Rs. 100000 for my and my husband mental harassment,wastage of time ,bear insecurity,pay extra due to the negligence of insurance company .why we will faith on any medical insurance company? We need justice. i have the proof final bill, query resolved by doctor,denial mail,UNITED HEALTHCARE PRE AUTHORIZATION form.estimate from the hospital every thing. I was not aware that we can do it through online we were looking after a lawyer in pune for the same from a long period as we were from noida.


  1. dr bansal

    sir, in case of claim no 1/771057 cashles for father of anil khanna , his father is pemitted by cghs rule tpo raise a 2nd claim when not fully covered by health insurance tpa
    for this your secification as to how much reimbursed per test/ per day hospital stay/ doctors’ visits/ room rent/ operation charges/ sundries/ pharmacy is a must
    already we have submitted his bill to our higher authorities and they ‘ve asked these details
    sir in absence of this they would be penalised very badly absolutely time bound and lot ot time [3 weeks already lapsed in getting these detail , essential for raising a2nd b ll]
    i would be eternally obliged to you for helping our patient get his due
    yhanking you
    v bansal
    cmo in charge noida sec 82


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