Hi,

Reimbursement Claim Ref id: BLR-0613-CL-0001401

Enrollment ID: BLR-NI-W0149-001-0000455-D

Inward No: BLR-0517855

W S RETAIL SERVICES LTD

VALID from 10/06/2012

Emp code: 19024

The above mentioned details is of the details of the claim request for my reimbursement for which the pending amount which was not approved earlier by telling silly rules by the TTK executives. The same was paid from our pocket to the hospital when the time of discharge though.

FFR: 12500/- & I had already submitted the medical billls for upto 3k. I want this to be approved at any cost. The maount for FFR was not approved by the TTK guys as they were stating that the doctors do not have to go for the same. Is that the insurance people who decides what treatment has to be given to a patient ?. My mother was admitted due to cardiac problems. Doctors was suppose to do Angioplasty for her, but luckily that was not required as they did FFR along with the Coronory Angiogram. TTK guys telling that FFR is not related to the Coronory angiogram. "Fractional Flow Reserve, or FFR, is a guide wire-based procedure that can accurately measure blood pressure and flow through a specific part of the coronary artery. FFR is done through a standard diagnostic catheter at the time of a coronary angiogram (a.k.a. cardiac catheterization). The measurement of Fractional Flow Reserve has been shown useful in assessing whether or not to perform angioplasty or stenting on "intermediate" blockages." Please refer https://ptca.org/ivus/FFR.html

The bill amount would have become more if the doctors gone for Angioplasty, but as I mentioned earlier luckily my mother was alright and doctors cured her issue completely with the help of FFR while doing Coronory Angiogram. Mine is a corporate insurance, still the insurance is not approved for me by telling silly rules. I complained to my higher officials & HR at my office and then thereafter I was asked to submit the bills once again. I did submitted the reimbursement form duly filled along with the original bills which has the senior doctor's sign too.

I had called up to the All india insurance help desk which is under INDIAN GOVERNMENT. They also advised me to how to provide the complaint against the same. I did'nt do that till now.

I am waiting to receive my complete pending reimbursement. Otherwise I will be forced to file a case against the hassle which I faced. Not only for me, a lot of other customers would have faced these kind of issues from the insurance company. When they want us to take or join any insurance how good they towards us are not the same after you contact them for claim regarding issues. Behave like least bothered. When I submitted the claim form the executive informed me that they will again discuss with their senior doctors and take the appropriate desicion it seems. I dont care any more silly rules, if TTK comes back again with those same. I will be forced to look forward with the legal actions to aquire JUSTICE to me and my family.

Thanking you all very much.

Regards,

SAI

8970552993