| Address: NOIDA UTTAR PRADESH |
| Website: www.nivabupa.com |
Dear Sir,
Sub: My insurance claim of Rs49, 350/ was not approved with irrelevant reasons by
Niva Bupa Insurance Company Ltd.
Reference: Policy No:[protected], Claim ID:1839992 and Member ID:15936295.
As per the Niva Bupa mail Dated26/06/2024, my claim amount has been denied with the reason the patient was admitted primarily for diagnosis and evaluation purpose and claim made is not payable under policy clause.4.1.4, (Investigation &Evaluation) which is not relevant here and not applicable since purpose is for proper diagnosis to administer appropriate wellness treatment and to undergo rejuvenation therapy at AYUSH hospital-SDM Institute of Naturopathy Institute of Naturopathy and Yoga Sciences - Bangalore( Nelamangala ) for 7 days residential treatment from 31st of May2024 to7th June 2024.This Ayush hospital is very essential to keep mind and body sound and maintain good health, and also to keep away from any diseases of insured person which is directly advantages for insurance company also. Before admitting to Ayush Hospital, I have informed the Niva bupa claim department 31/05/ 2024 by mail and also received immediate response with claim form attached for reimbursement of medical expenditures. Hospital has good infrastructure treatment facilities and various treatment facilities, which is very well equipped with all types of wellness treatment including Physiotherapy, Acupuncture, Colon treatment and Body Composition Analysis (BCA) proper diet to maintain the body wellness. The premise is well maintained with well-maintained with various plants and greenery plants and trees.
In your mail dated 26/06/2024 you have mentioned claim made not payable under policy clause 4.1.4 (investigation and evaluation) it is not correct and is not relevant, it is for the treatment of Diabetes by various therapy including yoga, pranayama, diet plan, weight reduction. Nutrition food and fruits, juices naturopathy and physical activities including swimming. For your kind information, One more condition is added which was not mentioned in my earlier policy -[protected], one more reason for not considering claim is, Non-Insulin -dependent diabetes mellitus, as per the NivaBupa policy page no: 4 under permanent Exclusions Para of any pre-existing disease is excluded such as item 1 Diabetes mellitus and its complications-(none means non-essential) Treatment for NIDDM includes a restriction in calories and carbohydrates, lipid and proteins by providing supplementation of diet with less carbohydrates with soluble fiber and magnesium salts, and the diet provided for meal is grain free with moderate salt and chilly.
Request to reexamine my application for claim made of Rs 49350 to approve since I am a senior citizen of 74years
Thaking you,
Your faithfully,
Prof H S DIVAKARA MURTHY, [protected]@gmail.com, [protected]
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