I was diagnosed with multiple ligament tear of the ankle ( Grade 2 and grade 3). The same was confirmed after MRI scan. Doctor suggested conservative treatment to avoid surgery. This involved 1 day hospitalization and total immobilization of the ankle with cast. Further weekly monitoring was done where cast was replaced eventually to weight bearing.
Even after submitting all required documents ( insurance came back 4-5 times with specific requirements each time), in the end they rejected the claim stating active line of treatment of doctor was in appropriate.
In simple words , they are challenging the treatment given by doctor and are rejecting the claim.
This is really frustrating, involved so much waste of time and arrogance on their part as no one even bothered to call and explain why claim is rejected.
Margao 403602, Goa