Dear All,
Your quoted feedback in email:
“
The Panel has opined that the claim has been assessed on the basis of reasonable charges which are the standard charges for the specific provider, consistent with those prevalent in the geographical area for identical or similar services. The net claim has been arrived at after deducting the charges towards non-payable items and consumables, as per Policy Terms and Conditions
“
However, Kindly explain the logic for below agreed terms for copayment in agreement:
The Copayment amount of INR 42262+ INR 142+ INR 207= 42611 is deducted however the policy holder Mrs Shetal Chowdhry is eligible for 100% Claim. Policy was taken when Mrs Shetal chowdhary was 58 Years old, Attaching recent policy of My Wife who is eligible for 100% claim upto 10 lakhs as per new policy.
This is my right as per agreement to receive 100% copayment amount.
Please provide justification why copayment is deducted and Starhealth is not willing to pay?
Regards,
Anoop Chowdhry