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TTK Healthcare Mediclaim : Service Review, Price & Claim Status info

TTK is better known as Tiruvellore Thattai Krishnamachari. TTK Health Care TPA Pvt Ltd was established in April 2002, with the task to provide top quality TPA services to Mediclaim policyholders and be the most favorite TPA in India. It is licensed by IRDA (Insurance Regulatory & Development Authority - License No. 016) and has been empanelled by leading insurance companies, both public sector and private, across different area of the country. TTK Health Care TPA Pvt Ltd believes customer satisfactions is of highest importance and constantly strives to achieve the same. TTK is joining with A R Doraisami Iyengar, a consumer goods firm in Chennai.

TTK Healthcare Mediclaim : Service Review, Price & Claim Status info

What is covered in a Standard Mediclaim Policy & what is excluded?

Insurance policy is for the defense of the insured against unexpected circumstances, which in mediclaim covers hospitalization for illness / injury / diseases as well as for certain benefits. Listed below is one benefit - Domiciliary hospitalization and the list of Standard Exclusions (that is not covered) of a Standard Mediclaim Policy.

Please note:- This is only a dig out of the standard policy. All terms and conditions as per the policy document issued by insuing Insurance Company is final for all purposes.

TTK is having fairly commendable presence in Gynecology, General Medicine, Pain Management, Chest Medicine, Gastro- Medicine and Orthopaedic Surgery. It offers the benefit of medical insurance, accident coverage and cash benefit in a single policy. Good health policy is brought to you by The New India Assurance Company Limited.

It is essential that every policyholder go through a 3 step cycle to settle a claim which is called:

Claim Intimation/Notification,
Claim document procurement and
Claim submission.

Above claims are explained in detail as follow:

Claim Intimation/Notification:

In case of hospitalization, under Mediclaim, the policyholder should principally make sure that the TTK is informed within 7 days of the hospitalization. Prior to the claim, this preliminary notice should be submitted to TTK and the same should include the following particulars:

  1. Name of the hospital or nursing home, attending doctor
  2. Name and address of the attending physician
  3. TTK Card Number / Policy and Certificate Number
  4. Nature of illness and/ or injury
  5. Bed number in the hospital etc

Claim Document Procurement:

The following documents are required to

  1. Hospital Bill with Receipt for payment along with the break up signed by the policyholder.
  2. Bills of medicine and doctors prescription.
  3. Discharge summary sheet from the hospital.
  4. Pathological reports and other investigation reports along with the doctor's authorization.
  5. In case of surgeons / consultants bills, kindly insist on a stamped, preferably numbered receipt.
  6. Other applicable details and documents linked to hospitalization.

Claim submission:

All the above need to be enclosed along with Claim Form which is obtained from the nearest TTK office or can be downloaded from the website. This claim form must be filled entirely and sent to the nearest TTK office.

Note: -
Only expenses relating to hospitalization will be reimbursed as per the policy taken. All non-medical expenses will not be reimbursed.
Know your Service Provider.

Please check your policy number to determine your service provider. You can refer to your cashless claim card for your policy number.

Claim provides Cashless Facility and Reimbursement Claim. Read the following to know what Cashless Facility is.

By using Cashless Facility one can walk into any of the networked hospitals, get treated, and walk out without paying any of the bills of hospitalization or medical bill. Across the country, TTK Healthcare has tied up with more than 4500+ network hospitals to provide cashless facility. This frees patient from the bother of having to pay the bills first and then claiming them from the insurance company as with other medical policies.

Reimbursement Claim is a claim in which the insured pays the expenses (which is or else claimable under his insurance contract) with the hospital and then claims for a reimbursement of those expenses.

Expenses and fees of TTK is as follow:

Room board and nursing expenses
Rs. 45,000 (@ Rs. 1,500/day for
30 days)
IC expenses
Rs. 24,000 (@ Rs. 3,000/day for
8 days)
Associated drug and doctor fees
Surgeon and anesthetist fees
Rs. 50,000
Drugs, oxygen, blood, etc.
Rs. 66,000
Total
Rs. 1,85,000

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