The following is the mail sent by Shri K.PANDU RANGA RAO to Shri Manish Kumar, New India Insurance Co.Mumbai to intervene in the matter of Cashless Facility.
Respected sir ,
This mail is with reference to the issues in the cashless LIC mediclaim group policy. Please find below my details.
Name : K Pandu Ranga Rao
Designation : Retired Senior Divisional Manager in LIC of India.
SR Number : 516906
Mobile Number : + 91 94412 37461
Since
long,I am suffering from obstructive sleep apponea .For this I am using
Cpap machine for over one year .The total expenditure for this was
over
70, 000/- which is not admissible in Mediclaim .It gave me lot of
comfort in breathing in sleep .But, for the past few months I am having
breathing problem even in day time .I approached the ENT Department of
Yashoda hospital,Secunderabad .After detailed examination ,CT scan of
neck and
nose and endoscopy of neck and nose , It was diagnosed as( reports were
forwarded to TPA)
1)
Development of crude mass in both nasal pathways making breathing difficult for me.
2) enlargement of
PALATINE UVULA thus restricting air path .
3) enlargement of tonsils grade 3 .
4) over growth of
tongue .
These can be corrected by major operation . But being 1) diabetic
2) BP patient 3) cardiac patient having undergone ANGIOPLASTY twice in
2003 and 2004,
this surgery for me was completely ruled out .But my breathing problem
is aggravating regularly .Hence it was decided to perform a surgery
using latest technology with
the help of radio frequency to rectify my nasal block in the presence
of cardiologist to give partial relief in breathing , without touching
others .This is more advanced than item no 13 in annexure 3 (
without hospitalization for 24 hours ) - TURBINECTOMY/Turbinnoplasty .
But due to my health condition,I was suggested for one day
hospitalization .The doctors were even hesitant to stop my cardiac
drugs (clopitab and ecosprin) for few days which is essential for this
procedure .
All my health problems ( Diabetic, hypertension and cardiac ailment) are
getting aggravated due to insufficient supply of oxygen due to
breathing problem. This procedure may not completely solve my problem
but partially restores my breathing.
THE PROPOSAL FOR TOTAL EXPENDITURE OF RS 49000/- ONLY BY
HOSPITAL TO TPA . THE SURGERY IS PLANNED ON 23 February,2016 .THE TPA HAS NOT
AGREED. IT IS SUGGESTED TO PAY CASH AND UNDERGO PROCEDURE AND LET
HOSPITAL CLAIM AMOUNT AFTERWARDS .WHAT EVER SETTLED BY TPA WILL BE REFUNDED
TO ME BY HOSPITAL(WHICH WILL TAKE MONTHS AND ILLOGICAL AS WELL) . BALANCE IS TO BORNE BY ME .
I
request your good selves to intervene in the matter and see to it that
TPA gives clearance for cashless procedure on a priority basis
considering that the procedure is on 23 February which is now less than
48 hours.
Thanking You,
WITH REGARDS .
YOURS FAITHFULLY
K.PANDU RANGA RAO
K.PANDU RANGA RAO
