Consumer Redressal

I was admitted in Woodlands Hospital Ltd, Kolkata from 5/3/2015 - 18/3/2015 due to a very large left upper polar cystic mass. The cyst + the left kidney had to be surgically removed. I have Mediclaim with New India Assurance since 2003 and the present Tpa is MD India Health Care Services Pvt Ltd. The cashless allowable was max. Rs 99,900/- (total expense was Rs 2,82,172/-). This was based on applicable sum insured of Rs 1.00 lakh + bonus 35%. My enhanced SI since 1/6/2011 was 2.00Lakhs + 35% bonus. While inquiring with the TPA, I was told that the applicable SI was based on the SI prior to 2011 ie. 4 years back and that this particular disease is a Pre- Existing one which requires a continuous coverage of a min. 48 months. So I was not eligible for the higher slab.I was told to refer to the brochure enclosed with the Mediclaim cert.where such kidney disease has been categorised as pre-existing. No such classification was found in my Goodhealth Policy brochure for that type.