I am registered with MEDI ASSIST past 2 years. Under the Corporate policy, for my parents are registered along with me.
Claim No :[protected]
Policy: Gold Plan
Patient Name : Chindunuru Nagamani
MAID : [protected]
Hospital : Sri Shankara Cancer Hospital And Research Centre, 1st Cross, Shankarapuram, Basavangudi, Bengaluru, Karnataka
Treatment Date : 29-June-2023 to 29-June-2023
Ailment Summary : Chemotherapy for Metastatic Breast Cancer.
Claimed Amount : Rs. 3, 44, 427
We had initiated the reimbursement process and provided all the documents, responded to multiple queries and still after so many days of back and forth, Medi Assist moved the claim to "Repudiated - awaiting insurer concurrence" state.
When I have enquired with the support team they are saying the limit for this claim has been exaushed. Please note that I'm having gold plan I'm having a floater sum of 12lac and 2 lac per person. Previously I have raised the similar claim for 367390 and it was approved for 305422. And right now the support team is saying that for this chemotherapy the cap limit is 2 lac if that is the case then how did i get 3 lac reimbursement previously.
Also, last financial year we went for chemotherapies and the basic sum has exhausted, at time the insurance company has deducted the amount from the floater sum only.
Im attaching the policy screenshot for Cancer care .
Kindly help me for this.
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