IFFCO Tokio General Insurance — claim rejected iffco tokio insurance


Please briefly explain why you feel this question should be reported .


Name of insurance co :  iffco tokio general insurance company ltd.            Phs id :  31173703
U/w office name :            gurgaon               name of beneficiary :      arpita kothari
Policy number : 52894951             name of proposer/employee :    aman jain
Group name :     samsung india electronics pvt ltd.             Policy period :    01/01/2018 to 31/12/2018
Employee number :         16788409             gender :               female
Address :             20th-24th floor two horizon centre dlf phase – 5 sec – 43 golf course road gurgaon – 122002                relation : wife
My claim inr 41819/- is denied.
Processing status :           insurer instruction received to communicate their decision of repudiation             claim processed date :               21/02/2018
Discharge voucher received date:             –              not payable expenses :  41819
Insurer says patient claim is related to anxiety neurosis which is an psychiatric disorder. The patient presented with complaints of vomiting, giddiness on 15-jan-18 at eternal hospital. Insured was diagnosed with anxiety neurosis with vit b12 deficiency. The submitted documents indicate oral medicines, iv medicines was administered. The the discharge summary submitted / retrieved in the douments indicate. Patient is treated for anxiety neurosis which is an psychiatric disorder. Hence the claim is being denied under clause no. 69 irda non payable item of the policy.It is a vitamin deficiency not a psychiatric disorder. I mailed paramount tpa regarding this but they denied claim,Please issue a notice to insurance company and get my claim success.Request you to look into the matter.

Arpita kothari 5 years 0 Answers 212 views 0

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