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, I was admitted with severe back pain and stomach spasm in Rukmani Birla Hospital Jaipur on advise of Docktor Ashish Sharma Head of Ortho
My National Insurance policy # is[protected]
NIC (National Insurance Corporation) has repudiated my claim stating this could have been treated in OPD, where as Doctor advise why admission was necessary was mailed to them ON Hospital letter head. Does the insurance company decide on patients treatment more than a doctors advise
I suffered severe back pain on 25th Oct 2022 and took injections and medicines for 2 days before being admitted on 28th when there was no relief
Doctor wanted complete examination, as it could also be case of pancreatis or any abdomen issue, since the pain was in lower abdomen and back. On 28th he Doctor asked me to come to hospital in ambulance immediately and get admitted
It was complete immobilization of lower half. This happened twice 25th Oct and 28th Oct.
On advice of reputed doctor ~ Dr Ashish Sharma who also happens to be Dean and Head of ortho in one of the most Reputed Hospital of Jaipur Rukmani Birla immediately advised admission on 28th suspecting something majorly wrong in spine or abdomen.
He tried treating me from 25th to 27th with injections and medicines, receipts of which are with me. When this happened on 28th. since I was in utmost pain I could not wait for TPA formalities of Insurance and paid from personal credit card immediately
Fortunately, in the MRI nothing major was found with spine except minor L5 irregularity. Was provided ultrasound therapy and injections through drip which released the pain to extent. Gastroenterologist was consulted and diagnosed abnormality is abdomen, suggested Ultrasound
FHPL & NIC suggest this could have been treated in OPD and did not require admission. Which the treating Doctor said was not possible. “they cannot overrule Doctor advise” “ I tried treating for 2 days through medicines and injection and finally asked you to get admitted”
Since I had no help available, and repudiation is subjective, if it was genuine case I let the court decide whether an Insurance company decides on patients treatment.
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