Rejection of cashless claim

Name of Complainant RAMJEE KOLLI
Date of ComplaintAugust 11, 2022
Name(s) of companies complained against
Category of complaint Insurance
Permanent link of complaint Right click to copy link
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Text of Complaint by RAMJEE KOLLI:

Dear team,
My father Sri kolli Satyanarayana was diagnosed with COVID -19 and was admitted to omni hospitals, visakhapatnam on 11.11.2021.
He has tata aig health insurance policy 0238452957 and the same was informed to hospital on admission.The treatment was carried out for covid-19 and the initial claim with reference no:2021111100153 was approved for Rs.85,000/-.
Doctors advised for discharge on 13.11.2021 and the same was informed to billing section.The bill amount for discharge was Rs.1,76,574/-
However the total claim was rejected on 13.11.2021 mentioning that “As per available information Case needs to be reviewed thoroughly with complete past medical history
and the same is not possible at this juncture in cashless.
Previous approval also stands null and void ”

We wish to inform you that covid-19 diagnosed for my father is not a pre-existing disease and the cashless claim needs to be approved.
Confirmation from omni hospitals has been sent to Tagicpreauth@fhpl.net and Preauth@tataaig.com with regard to the treatment carried out, which clearly mentioned that no pre existing ailments are responsible for covid-19 contracted by the patient Sri Kolli Satyanarayana and the expenses incurred were purely for covid-19 treatment only.

In view of the above, we request you to settle or process the cashless claim without any delay.
Kindly do the needful.

Thanks & regards,
Ramjee kolli,
M: 9885949439.

Image Uploaded by RAMJEE KOLLI:

Rejection of cashless claim

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