REJECTION OF CLAIM

Expenses of Rs.46646.46 are on account of FIRMAGON INJECTIONS which are prescribed treatment for prostate Cancer by TPA by treating them under post thus restricting it to 10% of sum assured which is fully utilized for other expenses.I wish to bring it to your notice that in case of Mr. Ramesh Bhai L Patel V/s. United India Insurance Co. Ltd. Award dated 09-08-2010 it was decided that the claim for hormonal therapy which was initially repudiated, was infact payable.

Now I am writing to both TPA and Insurance Company o reconsider the cliam in the light of this decision with a Copy to Office of the Insurance Ombudsman,

2/2 A, Universal Insurance Building,

Asaf Ali Road,

New Delhi – 110 002.

Kindly let me know your views on this.

Best regards

Ashok Singal

09818529331

New Delhi

3 Replies

oldestnewest
  • You can proceed - definitely you will receive

  • thanks.

    rgds

    ashok

  • i find it's worthwhile to take up the matter with the ombudsman if you have your facts right. Insurance companies rely on the fact that very few people will bother to challenge their unfair rulings. I have taken up a matter (not related to my cancer treatment) with the ombudsman here in Mumbai and won. I would be very interested to know if you win your case for payment for hormone therapy so that I can use it as a precedent as I too am on hormone therapy which costs around Rs 6000 a month

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