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whether to lodge complaint with ombudsman or file the case with consumer forum?
Share My TPA had paid Rs.64000 against the final bill of Rs. 88800!
No PPN agreemment was sent before admission! Hospital did not accept TPA!
After admission and after i paid Rs. 80000 advance, next day TPA executives spoke to the hospital
and made cashless admission but not returned my advance.
After discharge, I did not agree for the final amount and they increased by Rs.1 and then Rs.14000 after the matter
was reported to NIACL H.O./ R.M. etc.,
Asked for which of the items in the bills falls under exempted list and no answer received.
Whether filing complaint with Ombudsman is better or filing the case with the consumer court. I can ask for damages
for mental stress and legal expenses as compensation along with unpaid money. In case of Ombudsman, I need to
travel and loose a day's income etc., which is eqvt. to what I may get. Only consolation is winning the case.
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Reply
Hello Mohansundaram,
Apologies for the delayed response.
You should first file a complaint with the Ombudsman. If your complaint isn't resolved satisfactorily through that process, then you can consider taking the matter to the consumer court.
We've talked in detail about both these options in this article: https://www.beshak.org/insurance/opinion/articles/filing-insurance-related-complaints-in-india/
Do check it out! Thank you!