Ombudsman

UNITED INDIA INSURANCE COMPANY LIMITED
Divisional Office 010500

64, Armenian Street, Chennai-600 001
Phone No.25389793/25389794
Fax No.25386298
17.02.2011
The Insurance Ombudsman,

Jeevan Seva Annexe,
3rd Floor S V Road
Santacruz (W)
Mumbai 400 054
Dear Sir,
Re : Complaint against UIIC, Divisional Office 010500
Policy No.: 010500/2009/48410000622/4
Insured: Mr. Hrishikesh Sharad Vanarase
Your reference No. OMB/MUM/GI/1525/10-11 dtd.15.02.2011
With reference to your letter dated 15.02.2011 on the above subject, we hereby give
our unconditional and irrevocable consent for the Insurance Ombudsman to act as a
mediator between the Insurance Company and the Complaint and give his
recommendation for the resolution of compliant.
Yours faithfully,
(K THAYUMANASUNDARAM)
Sr. Divisional Manager

Phone No.25389793/25389794
Fax No.25386298
17.02.2011

Jeevan Seva Annexe,
3rd Floor S V Road
Santacruz (W)
Mumbai 400 054
Dear Sir,
Policy No.: 010500/2009/48410000622/4
WRITTEN STATEMENT
Anent to the above, we hereby submit the following points for your kind perusal and
doing the needful.
1. We have issued the Arogya Raksha Medicliam Policy under floater basis for the
sum insured of Rs.5,00,000/- for the period from 11.02.2010 to 10.02.2011 under
Policy No.010500/2009/4841000622/4 as per his proposal form routed through
M/s Indian Bank, Sadashiv Peth Branch, Pune.. This is a continuous renewal
Policy. Previous Policy No. 010500/2009/4841000012/1 from 11/02/2009 to
10/02/2010 for Rs.5,00,000/-. Both the policies are covering Self, Spouse,
Daughter and his Mother.
2. In his proposal form, he has opted TPA is M/s TTK Healthcare Services P Ltd
and the same is mentioned in the policy with full address of their address for ID
cards and Claim settlement.
3. Under this policy, the insured has claimed for his mother's treatment of Chronic
Anamia, Incisional Hernia, HTN for her treatment at Joshi Hospital, Pune for
the period from 07.11.2010 to 16.11.2010 and he submitted the entire papers to
M/s TTK Health Care Services P Ltd for reimbursement.
.. Page 2 ..
.. Page 2 ..
4. After verifying the records, the TPA M/s TTK Health Care Services P Ltd.
Comes to an conclusion that the treatment for pre-existing diseases which is not
covered under the first year policy. Hence, the claim was repudiated under
clause 4.1 as per terms and conditions of the policy.
5. We also issued a repudiation letter to the insured based on the recommendation of
our TPA and the terms and conditions of the Policy.
6. Regarding the Cash less facility extended by TPA depends upon the case and the
admissibility of the claim.
7. Exclusions clause 4.1 reads as pre-existing diseases are not covered under the
said policy for the first 3 continuous years of the policy.
8. As required, we enclose herewith the copy of the proposal form, copy of the
policy/ certificate for the year 2009 & 2010, policy terms and conditions, Claim
repudiation letter by M/s TTK dt. 07.12.2010 and our repudiation letter
dtd.10.12.2010 for your perusal and reference.
Thanking and assuring of our best attention at all times.
(K.THAYUMANASUNDARAM)
Encl: as above.
UNITED INDIA INSURANCE CO LTD

DIVISIONAL OFFICE: 010500
64, Armenian Street, Chennai 600 001
TF: 044-25389793 Fax No.044-25386298

REF:010500: ARG/OMBUDSMAN:09-10
Dt:28.11.2011
TTK Health Care Services P Ltd.

Anmol Palani
No.88, L2, G.N. Chetty Road,
T.Nagar
Chennai 600 017.
TF : 044-52024340/41/42
MOST URGENT
Sirs,
Re : Policy No.010500/48/09/41/0000622/4
Insured : Shri Hrishikesh Sharad Vanarase Complaint No. OMB:MUM:GI-1525/11/12
With reference to the above, we enclose a copy of the Award Ref No. OMB:MUM:G11525/11/12 dtd. 25.11.2011 passed by the Honble Insurance Ombudsman,Mumbai that Shri
Hrishikesh Vanarase is eligible for the claim amount as per policy terms 15% of Sum
insured or maximum of Rs. 30,000/- for his mother's medical expenses when she was
admitted in Joshi Hospita, Pune from 07.11.2010 to 16.11.2010 for the treatment Chronic
Anaemia, Incisional Hernia, HTN.
Therefore, we hereby inform you to settle the claim amount immediately as per the Award
after getting consent letter from the Insured.
Kindly comply the above Award at once and furnish the payment details to us.
Thanking you,
Yours faithfully,
Sr. Divisional Manager.

Encl: as above.
Copy to: Regional Office I, Health Department, Chennai 6 for information
Head Office, Health Department, Chennai 14. - for information
Regional Office II, Bharati Vidyapeeth Bhavan, 5 th Floor, L B Shastri Marg,
Pune-411030 for information.
The Insurance Ombudsman, Jeevan Seva Annexe, 3 rd Floor
S V Road, Santacruz (W), Mumbai 400 054 for information
Mr. Hrishikesh Vanarase, A-301, Twin Nest, S.No. 12/2/1, Behind Rajwada Hotel,
Someshwar Temple road, Pashan, Pune 411 008 for information & request you to send
consent letter to our TPA M/s Ttk Healthcare Services P Ltd., Chennai for their doing the
needful.

Phone No.25389793/25389794
Fax No.25386298
27.12.2011

Jeevan Seva Annexe,
3rd Floor, S V Road
Santacruz (W)
Mumbai 400 054
Sirs,
Re: Complaint against UIIC, Divisional Office 010500
Policy No.: 010500/2009/48410000622/4

Your reference No. OMB/MUM/GI/1525/10-11
With reference to the above, we hereby inform you that as per the above referred award, we
have settled the amount to the insured for Rs.30,000/- (Rupees Thirty thousand only)
towards the Medi-claim against the policy no. 010500/2009/48/41/000622/4 through our TPA
M/s TTK Healthcare Services P Ltd vide their cheque No.378203 dtd.24.12.2011 after
getting the consent letter from the insured.
This is for your kind information.
Thanking you,
Yours faithfully,

UIIC, DO:010500, Ch1.
Copy to : UIIC, Regional Office II, Bharati Vidyapeeth Bhavan, 5 th Floor, L B Shastri Marg,
Pune 411 030 - for information
Regional Office, Health Department, Chennai 6
Regional Office, Legal Department, Chennai 6
M/s TTK Healthcare Servics P Ltd., Chennai 17
TF: 044-25389793 Fax No.044-25386298
Dt:17.08.2010
Anmol Palani
T.Nagar
Chennai 600 017.
TF : 044-52024340/41/42
MOST URGENT
K/A Vidhya ,C. Asst Manager

Sirs,
Re : Policy No.010500/48/06/41/0003310/1
2007/48/41/0000047/05
Insured : Shri Sh Deepak Sharma Ombudsman Case No.GI/219/UII/09
Refer Yr Ltr dtd. October 6, 2009
With reference to the above, we enclose a copy of the Award dtd. 26.07.2010 received by us
on 17.08.2010 through our Regional Office I, New Delhi passed by the Honble Insurance
Ombudsman (Delhi & Rajasthan) on dtd. 26.07.2010 that Shri Sh Deepak Sharma is eligible
for hospitalization expenses at Kailash Hospital, Noida for the period from 08.12.2007 to
22.12.2007 along with 8% interest from 01.02.2008 to till the time payment is made.
Hence, we hereby inform you to settle the claim amount immediately as per the Award after
getting letter of acceptance from the insured and furnish the payment details to us.
Thanking you,
Yours faithfully,

Encl: as above.
Copy to: 1. Office of the Insurance Ombudsman, (Delhi & Rajasthan), Universal Insurance
Building, 1st Floor, 2/2A, Asaf Ali Road, New Delhi 110 002 TF No. 23239633 23239611 for
information
2. Shri Sh Deepak Sharma, N0.246, Gali No.14, Balbir Nagar Extn.
Shahdara,Delhi, New Delhi for information.

Phone No.25389793/25389794
Fax No.25386298
30.01.2012
Office of the Insurance Ombudsman(M.P. & C.G.)
Janak Vihar Complex,
2nd Floor, 6 Malviya Nagar (Opp. Airtel Office)
BHOPAL 462 003 (M.P.)
Tel:0755-2769201/2769202
Dear Sir,
Policy No.: 010500/2011/48410000176/4
Insured: Mr. Prakash Patil
Your reference No. GI/UII/1201/73 dtd.19.01.2012
With reference to your letter dated 19.01.2012 on the above subject, we hereby give our
unconditional and irrevocable consent for the Insurance Ombudsman to act as a mediator
between the Insurance Company and the Complaint and give his recommendation for the
resolution of compliant.
Yours faithfully,

Phone No.25389793/25389794
Fax No.25386298
30.01.2012
Office of the Insurance Ombudsman(M.P. & C.G.)
Janak Vihar Complex,
2nd Floor, 6 Malviya Nagar (Opp. Airtel Office)

BHOPAL 462 003 (M.P.)
Tel:0755-2769201/2769202
Dear Sir,
Policy No.: 010500/2011/48410000176/4
Insured: Mr. Prakash Patil
Your reference No. GI/UII/1201/73 dtd.19.01.2012
WRITTEN STATEMENT
Anent to the above, we hereby submit the following points for your kind perusal and doing the
needful.
1. We have issued the Arogya Raksha Medicliam Policy under floater basis for the sum
insured of Rs.2,00,000/- for the period from 07.06.2011 to 06.06.2012 under Policy
No.010500/2011/4841000176/4 as per his proposal form routed through M/s Indian
Bank, Ashok Garden Bhopal Branch, Bhopal. This is a fresh policy and the policy is
covering Self, Spouse, and his son.
2. In his proposal form, he has opted TPA is M/s TTK Healthcare Services P Ltd and the
same is mentioned in the policy with full address of their address for ID cards and
Claim settlement.
.. Page 2 ..
.. Page 2 ..
3. Under this policy, the insured has claimed for his wife's treatment for G3 P1 A1 L1missed abortion at Anushree Hospital, Bhopal for the period from 07.08.2011 to
09.08.2011 and he submitted the entire papers to M/s TTK Health Care Services P
Ltd for reimbursement.
4. After verifying the records, the TPA M/s TTK Health Care Services P Ltd. Comes to a
conclusion that the treatment is for traceable to pregnancy which is not covered
under the policy condition 4.13 of the policy. Hence, the claim was repudiated under
Exclusions clause 4.13 reads as:
treatment arising from or traceable to pregnancy (including voluntary termination of
pregnancy) expenses are not covered under the scope of the policy.
5. Besides, for availing maternity benefits 9 months waiting period is there from the date
of inception of the policy. Here, the insured had a claim after 2 months from the date
of the commencement of the policy. Hence the claim could not be entertained under
Maternity Benefit Extension also.
6. We have also issued a repudiation letter to the insured based on the recommendation
of our TPA and the terms and conditions of the Policy.
7. Further the matter was referred to our Panel of Doctors at our Head Office and they
opined that the procedure of D & C has been done only for the sake of abortion in this
case. Hence, the decision taken by our TPA M/s TTK is justified.
8. As required, we enclose herewith the copy of the the policy/certificate policy terms
and conditions, Claim repudiation letter by M/s TTK dt. 09.09.2011 and our
repudiation letter dtd.19.09.2011 for your perusal and reference.

Encl: as above.

TF: 044-25389793 Fax No.044-25386298
Dt:01.02.2011

Anmol Palani
T.Nagar
Chennai 600 017.
TF : 044-52024340/41/42
Sirs,
Re : Policy No.010500/2011/4841/0000176/4
Insured : Shri Mr Prakash Patil

Ombudsman letter Ref. NO. GI/UII/1201/73 dt. 19.01.2012
With reference to the above, we enclose the copy of Insurance Ombudsman, Bhopal letter
dt. 19.01.2012 which is self -explanatory and for that we request you to send your letter with
detailed explanation along with your panel doctors opinion with regard to justification of
repudiating the above claim directly to Office of the Insurnace Ombudsman (M.P. & C .G.)
Bhopal under a copy marked to us to strengthen our decision.
Please ensure that your fullest co-operation is extended in the entire proceedings of this
case.
We also enclose herewith the original claim file received from your end for our verification.
Thanking you,
Yours faithfully,

Encl: as above + Original Claim file.

Phone No.25389793/25389794
Fax No.25386298
07.03.2012
Office of the Insurance Ombudsman
Fathima Akhtar Court
4th Floor, 453 (old NO.312)
Annasalai, Teynampet,
Chennai 600 018
Tel: 24333668
Dear Sir,

Policy No.: 010500/2011/48410000247/13
Insured: Mr.P Gomathi Sundaravel
Your reference No. 11.04.1771 dtd.29.2.2012
between the Insurance Company and the Complaint and give your recommendation for the
Yours faithfully,

Phone No.25389793/25389794
Fax No.25386298
07.03.2012
Office of the Insurance Ombudsman
4th Floor, 453 (old NO.312)
Annasalai, Teynampet,
Chennai 600 018
Tel: 24333668 / 24335284
Dear Sir,
Policy No.: 010500/2011/48410000247/13
Insured: Mr.P Gomathi Sundaravel
Your reference No. 11.04.1771 dtd.29.2.2012
WRITTEN STATEMENT
needful.
1. We have issued the Arogya Raksha Medicliam Policy under floater basis for the sum insured
of Rs.1,50,000/- for the period from 21.07.2011 to 20.07.2012 under Policy
No.010500/2011/4841000247/3 as per his proposal form routed through M/s Indian Bank,
N.G.O. Colony Branch, Tirunelveli. This is a renewal policy incepting from 27.07.2010 and
the policy is covering Self, Spouse, and his daughter.
2. In his proposal form, he has opted TPA M/s TTK Healthcare Services P Ltd and the same is
mentioned in the policy along with their full address for issuance of ID cards and Claim
settlement.
.. Page 2 ..
.. Page 2 ..
3. Under this policy, the insured has claimed for his wife's treatment for Tubal Pregnancy-Left
Tube-Laparotomy done at Prasanna Kumaran Hospital, Madurai
and he submitted the
entire papers to M/s TTK Health Care Services P Ltd for reimbursement.
4. After verifying the records, the TPA M/s TTK Health Care Services P Ltd settled the claim for
Rs.7500/- under the policy condition no.1.7 (Extension of Maternity expenses benefit )
Policy Conditon clause 1.7 reads as:
Maternity Expenses Benefit means treatment taken in Hospital/Nursing Home from or
traceable to Pregnancy, child birth including normal Casesarean section, Maternity and Baby
care will be covered upto the value of 5% of the total Sum Insured.
5. Since the policy condition clearly mentions that any treatment related to pregnancy will fall
under the capping limit and so that the claim was settled by our TPA for Rs.7500/- being 5%
of the total sum insured of Rs.1,50,000/.
6. Our further representation with our higher authroities at our Regional Office have also
confirmed that the claim settled by our TPA is in order since the policy condition clearly
mentions that any treatment related to pregnancy will fall under the capping limit and it attract
the policy condition clause 1.7.
Hence, we are not in a position to honour the expected quantum of claim as requested by the
Insured.
As required, we enclose herewith the copy of the the policy/certificate and policy terms and
conditions for your perusal and reference.
Besides we would like to bring the following for your kind attention that conditions No. 5.11 of
the policy which read as:
If any dispute or difference shall arise as to the quantum to be paid under the policy
(liability being otherwise admitted) such difference shall independently of all other
questions be referred to the decision of a sole arbitrator to be appointed in writing by
the parties or if they cannot agree upon a single arbitrator within 30 days of any party
invoking arbitration the same shall be referred to a panel of three arbitrators,

comprising of two arbitrators, one to be appointed by each of the parties to the
dispute/difference and the third arbitrator to be appointed by such two arbitrators and
arbitration shall be conducted under and in accordance with the provisions of the
Arbitration and Conciiation Act, 1996.
This is for your kind information.

Encl: as above.

Phone No.25389793/25389794
Fax No.25386298
26/03/2012
Office of the Insurance Ombudsman,

4th Floor, 453 (Old No.312) Anna Salai,
Teyanampet,
Chennai 600 018.
TF:24333668/24335284
Dear Sir,
Policy No.: 010500/2011/4841000247/13
Insured: Mr P Gomathi sundarvel
Your reference No. 11.04.1771/2011-12 dtd.20.03.2012
Authorization Letter
With reference to your letter dated 20.03.2012 on the above subject, we hereby
authorised Shri R Thiagu, Asst.. Manager who is well conversant about the case to
appear on behalf of our company on 24th April, 2012 at 12.00 Noon at your office
address alongwith Officials of our TPA M/s TTK Healthcare Services P Ltd.
Chennai as mentioned in your letter.
Yours faithfully,

Phone No.25389793/25389794
Fax No.25386298
25.05.2012
Pulinat Building, 2nd Floor,
Opp. Cochin Shipyard, M.G. Road,
Ernakulam, Kochi 682 015
Ph 2358759 Fax: 2359336
Sirs,
Policy No.: 010500/2011/48410000298/15
Insured: Mr.P.C. Paul
Your reference No. 10/KCH/GI/11-004-1023/11-12 dt. 29.03.2012
between the Insurance Company and the Complaint and give your recommendation for the
Yours faithfully,

Phone No.25389793/25389794
Fax No.25386298
25.05.2012
Pulinat Building, 2nd Floor,
Opp. Cochin Shipyard, M.G. Road,
Ernakulam, Kochi 682 015
Ph 2358759 Fax: 2359336
Sirs,
Policy No.: 010500/2011/48410000298/15
Insured: Mr.P.C. Paul
Your reference No. 10/KCH/GI/11-004-1023/11-12 dt. 29.03.2012
WRITTEN STATEMENT
needful.
1. We have issued the Arogya Raksha Medicliam Policy under floater basis for the sum insured
of Rs.1,00,000/- for the period from 27.07.2011 to 26.07.2012 under Policy
No.010500/2011/4841000298/15 as per his proposal form routed through M/s Indian
Bank,Pallimukku (Ernakulam Bot) Branch, Ernakulam. This is a renewal policy incepting from
08.07.2008 and the policy is covering Self, Spouse, and his daughter.
2. In his proposal form, he has opted TPA M/s TTK Healthcare Services P Ltd and the same is
mentioned in the policy along with their full address for issuance of ID cards and Claim
settlement.
.. Page 2 ..
.. Page 2 ..
3. Under this policy, the insured has claimed for his wife's treatment for CA OVARY on Out
Patient treatment and he submitted the entire papers to M/s TTK Health Care Services P Ltd
for reimbursement.
4. After verifying the records, the TPA M/s TTK Health Care Services P Ltd has repudiated the
claim under conditions clause 2.4 of the policy since there in no hospitalisation and only OPD
treatment is given.
Policy Conditon clause 2.4 reads as:
Proceedures/treatments usually done in out patient department are not payable under the
policy even if converted as in -patient in the hospital for more than 24 hours or carried out in
Day Care Centre.
5. We have also issued a repudiation letter dt.25.10.2011 to the insured based on the
recommendation of our TPA and the terms and conditions of the Policy.
As required, we enclose herewith the copy of the the policy/certificate and policy terms and
conditions for your perusal and reference.
Encl: as above.

TF: 044-25389793 Fax No.044-25386298
Dt:18.06.2012

Anmol Palani
T.Nagar
Chennai 600 017.
TF : 044-52024340/41/42
MOST URGENT

Sirs,
Re : Policy No.010500/2010/48/41/0000156/15
Insured : Shri Ashok Kumar Gaur
Ombudsman Case No.GI/451/UII/11
With reference to the above, we enclose a copy of the Award dtd. 16.05.2012 received by us
on 18.06.2012 through our Regional Office I, New Delhi passed by the Honble Insurance
Ombudsman (Delhi & Rajasthan) on dtd. 16.05.2012 that Shri Ashok Kumar Gaur is eligible
for hospitalization expenses for Rs.1,24,123/-.
Hence, we hereby inform you to settle the claim amount immediately as per the Award after
getting letter of acceptance from the insured and furnish the payment details to us.
Thanking you,
Yours faithfully,

Encl: as above.
Copy to: 1. Office of the Insurance Ombudsman, (Delhi & Rajasthan), Universal Insurance
Building, 1st Floor, 2/2A, Asaf Ali Road, New Delhi 110 002 TF No. 23239633 23239611 for
information
2. Shri Ashok Kumar Gaur, IX/1056 Patel Gali, Subhash Road, Gandhi Nagar,
Delhi 31 Mob 09811323366- with a request to submit the letter of
acceptance for full and final settlement of the claim for Rs.1,24,123 to M/s
TTK, Chennai immediately for their doing further
3. Grievance Dept., Regional Office- 1, 8th Floor, Kanchanjunga Building, 18,
Barakhamba Road, New Delhi 110 011 for information
4. Regional Office, Grievance Dept., Chennai 6 for information

Phone No.25389793/25389794
Fax No.25386298
05.11.2012
BY REGD. POST

(Maharashtra & Goa) Mumbai
Jeevan Seva Annexe,
3rd Floor, S V Road
Santacruz (W)
Mumbai 400 054
Sirs,
Policy No.: 010500/2010/48410000307/2
Insured: Mr. Jitendra Talreja
mediator between the Insurance Company and the Complaint and give the
Yours faithfully,

Phone No.25389793/25389794
Fax No.25386298
05.11.2012

(Maharashtra & Goa) Mumbai,
Jeevan Seva Annexe,
3rd Floor, S V Road
Santacruz (W)
Mumbai 400 054
Sirs,
Policy No.: 010500/2010/48410000307/2
Insured: Mr. Jitendra Talreja
WRITTEN STATEMENT
doing the needful.
We have issued the Arogya Raksha Medicliam Policy under floater basis for the
M/s Indian Bank, Andheri Branch, Mumbai. This is a fresh Policy covering Self,
Spouse, Son, Father and his Mother.
In his proposal form, he has opted TPA is M/s TTK Healthcare Services P Ltd
Under this policy, the insured has claimed for his mother's treatment and he
submitted the entire papers to M/s TTK Health Care Services P Ltd for
reimbursement.
.. Page 2 ..
.. Page 2 ..
After verifying the records, the TPA M/s TTK Health Care Services P Ltd.
Comes to an conclusion that the treatment for pre-existing diseases which is not
covered under the first year policy. Hence, the claim was repudiated under
Exclusion Clause 4.1 reads as: All diseases/injuries which are pre-existing when
the
cover incepts for the first time. However, this condition is waived if the
policy has been continuously insured/renewed for a period of consecutive three
years with any of the Indian Insurance Companies and no claim has been reported.
After that the Insured have claimed that he had policies with M/s New India
Insurance Co. Ltd. from 2001 to 2011 and request us for re-consideration of his
claim. Based on that, we have instructed to our TPA M/s TTK Health Care
Services to collect the previous insurance/claim details from the Insured as well
as from the previous Insurer for reconsidering the claim subject to exclusions,
terms and conditions of the policy and the copy of the letter is marked to the
Insured also.
Our TPA has also written a letter to the Insured regarding this issue but we are
yet to receive the copies of the previous year insurance and claim details from
the Insured. Hence, the claim is pending for want of requisite documents from
the Insured. As soon as, the receipt of the requisite documents from the Insured,
they may reconsider the claim accordingly.
As required, we enclose herewith the copy of the proposal form, copy of the
policy/ certificate for the year 2010-2011 policy terms and conditions for your
perusal and reference.
Encl: as above.

Phone No.25389793/25389794
Fax No.25386298
09.11.2012

(Maharashtra & Goa) Mumbai
Jeevan Seva Annexe,
3rd Floor, S V Road
Santacruz (W)
Mumbai 400 054
BY REGD. POST
Sirs,
Policy No.: 010500/2011/48410000455/9
Insured: Mr. Shinde Amol Popatrao
mediator between the Insurance Company and the Complaint and give the
Yours faithfully,

Phone No.25389793/25389794
Fax No.25386298
09.11.2012

(Maharashtra & Goa) Mumbai,
Jeevan Seva Annexe,
3rd Floor, S V Road
Santacruz (W)
Mumbai 400 054
Sirs,
Re : Re : Complaint against UIIC, Divisional Office 010500
Policy No.: 010500/2011/48410000455/9
Insured: Mr. Shinde Amol Popatrao
WRITTEN STATEMENT
doing the needful.
We have issued the Arogya Raksha Medicliam Policy under floater basis for the
M/s Indian Bank, Bhavan's Campus Branch. This is a fresh Policy covering Self,
Spouse, Daughter, Father and his Mother.
In his proposal form, he has opted TPA is M/s TTK Healthcare Services P Ltd
Under this policy, the insured has claimed for his wife's treatment for Dengue Fever at
Aastha Nursing Home, Andheri West, Mumbai for the period from 19.08.2012 to
24.08.2012 and he submitted the entire papers to M/s TTK Health Care Services P
Ltd for reimbursement.
.. Page 2 ..
.. Page 2 ..
After verifying the records, the TPA M/s TTK Health Care Services P Ltd has
sanctioned the claim for Rs.19,852/- disallowing Registeration fee and non
medical based on policy terms and conditions. The claim was settled through
ECS on 23.10.2012 . (Ref: Transaction ID EFT-12A22N5615J01331.)
We hereby enclose the copy of the claim computation sheet and e-mail
confirmation of claim settlement note from our TPA M/s TTK Health care
Services P Ltd. for your verification and reference.
As required, we enclose herewith the copy of the proposal form, copy of the
policy/ certificate for the year 2010-2011 policy terms and conditions for your
perusal and reference.
Encl: as above.

Ombudsman

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UNITED INDIA INSURANCE COMPANY LIMITED

Divisional Office 010500

The Insurance Ombudsman,

UNITED INDIA INSURANCE COMPANY LIMITED

The Insurance Ombudsman,

Thanking and assuring of our best attention at all times.

UNITED INDIA INSURANCE CO LTD

TF: 044-25389793 Fax No.044-25386298

TTK Health Care Services P Ltd.

Sr. Divisional Manager.

UNITED INDIA INSURANCE COMPANY LIMITED

The Insurance Ombudsman,

Policy No.: 010500/2009/48410000622/4

Sr. Divisional Manager

K/A Vidhya ,C. Asst Manager

Sr. Divisional Manager.

UNITED INDIA INSURANCE COMPANY LIMITED

UNITED INDIA INSURANCE COMPANY LIMITED

2nd Floor, 6 Malviya Nagar (Opp. Airtel Office)

repudiation letter dtd.19.09.2011 for your perusal and reference.

UNITED INDIA INSURANCE CO LTD

TTK Health Care Services P Ltd.

Insured : Shri Mr Prakash Patil

Sr. Divisional Manager.

UNITED INDIA INSURANCE COMPANY LIMITED

Re : Complaint against UIIC, Divisional Office 010500

UNITED INDIA INSURANCE COMPANY LIMITED

invoking arbitration the same shall be referred to a panel of three arbitrators,

This is for your kind information.

UNITED INDIA INSURANCE COMPANY LIMITED

Office of the Insurance Ombudsman,

UNITED INDIA INSURANCE COMPANY LIMITED

UNITED INDIA INSURANCE COMPANY LIMITED

Thanking and assuring of our best attention at all times.

UNITED INDIA INSURANCE CO LTD

TTK Health Care Services P Ltd.

K/A Vidhya ,C. Asst Manager

Sr. Divisional Manager.

UNITED INDIA INSURANCE COMPANY LIMITED

Office of the Insurance Ombudsman,

UNITED INDIA INSURANCE COMPANY LIMITED

Office of the Insurance Ombudsman,

UNITED INDIA INSURANCE COMPANY LIMITED

Office of the Insurance Ombudsman,

UNITED INDIA INSURANCE COMPANY LIMITED

Office of the Insurance Ombudsman,

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