Claim denied by New India, Medi Assist

My Father is suffering from Diffused Large B Cell Lymphoma from past 2 months. He is being treated in Narayana Hrudayalaya Mysore. He has been purchasing the New India Assurance Medical policy from 2010 onwards. Even this year, the policy has been renewed.

I would like to complain about what the MEDI ASSIST is doing, so that it could be helpful for some one who is going to take new policy from NEW INDIA ASSURANCE.

Below is the Chronological events happened from 4th December 2015:

On 4th Dec 2015 12:06 PM, Initiated the Cashless hospitalization process at Narayana Hrudayalaya as treatment for Diffuse Large B Cell Lymphoma.

On 4th Dec 2015 12:11 PM, received confirmation from Medi Assist on the claim and Claim # was generated: 91646772.
So it was clear that the Medi Assist was aware of treatment being done for Lymphoma.

On 4th Dec 2015 1:31 PM, We got reply from Medi Assist regarding the addional information needed:
+ Case History
+ Doctor’s Note

On 7th Dec 2015 11:45 PM, We provided the Case History with Doctor’s Note as well. Even here it was clearly mentioned as diagnosis done for Diffused Large B Cell Lymphoma.

On 7th Dec 2015 2:33 PM, Medi Assist came back asking for the details of the previous policies held with New India Assurance, i.e policies from 2010 to 2014. Being a insurance company i still do not understand the need of that since all the details are readily available with them. We called up the customer care and made them understand the same.

On 7th Dec 2015 7:35 PM, Medi Assist came back with the point of re-submitting the Case History

On 8th Dec 2015 12:35 PM, We once again consulted the doctor and got the Case History re-written and same was submitted to the Insurance.

On 8th Dec 2015 3:19 PM, Medi Assist came back for providing the “Discharge Summary” and “Final Bill” for processing.

On 8th Dec 2015 4:40 PM, Hospital re-submitted the Final Bill and Discharge Summary to the Medi Assist.

On 8th Dec 2015 6:00 PM, When checked the status of the Claim, it was showing as “Denied”, when asked about the reason, it was mentioned as “Diffused Large B Cell Lymphoma” is not covered under policy.

Where as in the New India Assurance policy portal it is clearly mentioned as Lymphoma is convered under Insurance policy.

Chirdeep Kumar
Gokulam 3rd stage, Mysore 570002, Karnataka
Email: chirdeep300] / 09/12/2015 / 11:19 am

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