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1. With in maximum how many hrs or days TPA must sanction cashless request from a empaneled hospital against valid policy??
2. With in maximum how many days claims are supposed to be settled as per IRDA guidelines?
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Replied on Sunday, August 28, 2011 2:17 AM
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 brkhanna (Guest)
You have stated in the third para related to TPA that TPA also collects premium.Is it permitted by IRDA regulations for TPAs?
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Replied on Monday, April 30, 2012 6:10 AM
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(Guest)
Q. MY FATHER WAS ADMITED IN APOLLO HOSPITAL, KOLKATA ON 17.1.2013 AT 2.45PM, AND RELEASED ON 21.1.2013 AT 9.45AM. HOSPITAL AUTHORIYT SEND THE FINAL BILL AT 10.00AM ON 21.1.2013 FOR CASHLESS APPROVALTO TPA [Emeditek] FOR 5 (FIVE) DAYS. BUT TPA SEND THE APPROVAL AT 4.30PM FOR 4 (FOUR) DAYS, BECAUSE THR 5TH DAY NOT COVERING 24 HOURS. WHAT IS THE RULE OF IRDA and AM I CASH BACK FOR THE 5TH DAY'S AMOUNT ON REIMBURSEMENT BASIS?
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Replied on Thursday, January 24, 2013 3:56 AM
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Health insurance consists of Pre Hospitalisation, Hospitalisation and Post Hospitalisation. But normally it is seen that Pre and post hospitalisation are not cared by TPAs. They pay only for hospitalisation in cashless claims to hospitals. If in a cashless claims, if an insured is late to intimate to TPA while still in Hospital, the tPA does not entertain cashless service. What are the reasons ?
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Replied on Friday, January 25, 2013 12:59 AM
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Kindly let me know if it is obligatory to have the services of TPA while purchasing the Mediclaim Policy?Kindly reply at the earliest as I am to renew my Mediclaim Policy next month,and I am not happy with the services of my existing TPA.Kindly also let me know,whom to complaint against the TPA for the unsatisfactory services of TPA.
An early reply to my querry will be a big favour as I understand that the fee payable to TPA is by the Policy purchaser.
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Replied on Monday, November 24, 2014 5:42 AM
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