Cashless Claim Denied by Oriental Insurance Company without any valid reason

Writing to you with regards to the unjustified way we have been denied cashless treatment from one of your TPAs Medi Assist India. Our patient was admitted to Max Noida-19 on the 21st and the TPA didn't respond appropriately to our submissions asking for discharge summary and final bill while the patient was still undergoing treatment in ICU and still is. They didn't process our file till we went to their Delhi ITO office on 27th Jan. This is sheer mental harassment while the patient's family is running around pillar to post seeking medical help. The claim was denied on 27th itself (claim#16194286) citing "multiple complications" and "suspected" PED based on case summary made by the emergency doctor available at the time the patient was brought to the hospital. Later on, after TPA's query, it was stated by the hospital clearly that the patient had no previous history of DM and Hypertension at the time of admission. After the denial of the first claim, a reconsideration mail was sent to the TPA with revised case summary (claim#16230228) by the treating doctor based on detailed test reports and other diagnosis and the resulting final treatment that the patient is undergoing which clearly states no previous history of suspected PEDs like kidney infection, DM or Hypertension. In the final summary, the doctor has clearly stated that the root cause of any infection to kidney or other parts is pneumococcal meningitis and not the other way round. However, citing the previous denial, the second reconsideration was also denied. Sir - this approach of TPA has caused a double whammy for us: we have to pay all the amount in lakhs from our pocket and we have been asked to cough-up hospital expenses on non-GIPSA rates which are extremely high. TPA has clearly asked us to approach IRDAI citing helplessness even after visiting them twice and confronting their personnel for a valid explanation. Sir - this is mental harassment and fleecing patients of their savings. TPA tells us that "cashless isn't your right" while I beg to differ as a patient takes up cashless insurance to save himself/herself from rainy days so this callous attitude of TPA violates a citizen's "right to health". Please advice on the way forward.