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Letter to Health insurance company for clarification about deduction

Write a letter to the officer of your health insurance company who has not approved the full claim amount,

but has deducted few amount for a reason or terms you are not aquainted with. Sometimes without a valid reason your approved amount is deducted and you are satisfied by few sentences of terms and condition; which may not be in the list of condition. This happen because normal people even do not read the terms and condition carefully.

In that case you can send an email to the health insurance TPA and an email copy to the Health insurance company for clarification regarding the deduction. Hope your issue will get a very quick solution, because written document is always a concrete way to fight for your grievances. Here is the format of the email. This email is just for case that has got solution. Your case may be different from this , but written communication can solve your grievances. Also there if it is not solved by the company and your are sure that your point is valid then you can write your grievance on IRDA portal [IGMS] by creating an ID and password.

Dear Sir,

This is for your kind information that I want to say about the approval amount for my left eye operation. The total package value is Rs 40000.00 [ as an example amount] as instructed by the hospital and you know this. You have shown the deduction of Rs 5000.00. on the approval email. To the best of my knowledge, I think you have shown this deduction for an injection. Doctor told me that this injection will be needed at the time of operation.

Last year I have gone for same type of operation for my right eye and I have been granted the injection's amount. Please write the valid reason for this deduction.

As far I know , I should get full value Rs 40000 for my left eye operation. Please reply soon as the operation date is on 22-10-2017.

Letter or email to Health insurance company for clarification about deduction

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