Complaint Details

Status : Un-Resolved Un-Resolved
Complaint No
: 0000151/2011
Category : Insurance
Date : 02-03-2011
Subject Line : Complaint against Genins India TPA Ltd & United In
     
Complainant : Nitin N Ghodke
Address : B-002, Shravandhara,Sasanenagar Hadapsar
     
Complainee : Genins India TPA Ltd & United India Insurance
Address :

 

Complaint Details
Hi,

Below complanint has been already raised with IRDA but no updates sicne last couple of months, for more details please find attached emails.
I had raised prior sanction from Poona Hospital to Genins India; my father was suffering with left Eye sight (Vascular endothelial growth) problem since last couple of months.
Poona hospital has diagnosed reason and suggested Eye injections, which need pre hospitalization & diagnosis & intra eye injection this injection needs to be ejected under observation of skilled doctors and need Operation Theater & all necessary equipments.
Last two claims which was made by me got approved by Genins India (Month Dec 2009 & Feb 2010), approval letters & bills are with me.
After raising prior sanction of claim to Genins India in the month of April 2010, they have rejected claim with reasoning of age factor, I also checked exclusive terms of Genins India’s policy for more details, but no where it has been mentioned.
I also had word with their doctor in this regards asked explanation about, why they had sanctioned this type of claims earlier.
In this regards, I had word with MUGDHA (Genins India) who has suggested having word with Dr.Abbdul (Genins India Mumbai) who has rejected this claim, but clue less in this matter.
I would like to request you to look in this matter ASAP, This surgery & treatment total cost was around 55 K.
They have given explanation of Age related AMD & also told me that they got circular from HO.
Really uncertain about this reason, after all they have misguided me.
I have all documents (old bills, quotation etc which got sanctioned in earlier case) with me and planning to file complaint against this under consumer court.
Request you to look into the matter.
Thanks,
Nitin Ghodke
Genins card id is:- GIUN0500076470
Cell Number: - 9850123723

Replies

Date: 2011-03-04 13:28:43
Subject: Complaint against Genins India TPA Ltd & United In
Reply: Dear Mr. Nitin Ghodke

We are in receipt of your complaint but your attachment is not getting opened. Kindly resend it or send a hard copy at the following address.

Thank you,

Divya Nair

Council for Fair Business Practices
Great Western Building, 130/132, Shahid Bhagat Singh Road, Mumbai 400 023.
Tel : 2288 5249 / 2284 2590 Fax : 2284 4783
Email : cfbp@mtnl.net.in/ cfbpoffice@gmail.com Website : www.cfbp.org/ www.ccrc.in
 

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