| Address: | Mumbai Suburban, Maharashtra |
I(ravi nair) have taken insurance(policy no 421500/Gmc/2012/1731_ex) for my mother(rethi menon) through mediassist(tpa) . Her ID card number is [protected]. On 23/12/12, she was admitted in casualty(emergency ward) in fortis hospital, mulund due to severe pain on right leg. She was not able to walk and sleep. Later after doing mri and series of xray scan, it was made clear that the pain is arising as result of some irregularities in discs on the spine. She has been admitted for 2 days in the same hospital. After undergoing treatment for 2 days under the guidance of ortho surgeon(dr. Vikas gupte), she was discharged after the pain has reduced.
I made the final bill payment and submitted the discharge letter, original bills, mri/Xray scan reports to mediassist for reimbursement. After following up repeatedly, I was told that the claim got rejected as there was no valid and active line of treatment.
For the problem(multilevel disc dessication with end plate changes creating acute pain in right gluteal region on low back which affected her back and legs due to which she was not able perform any body movement)identified after the diagnosis, she was admitted in the emergency ward because of severity of the problem. However these problems can never be a treated by surgery as per ortho surgeon who treated her. This problem can only be treated by ailing medicines followed by continous monitoring. If required, the type and quantity of medicines will change. Also both feet were tied with ropes supporting heavy weights at other end. She was discharged only after she was declared fit for movements. Therefore the treatment was completely valid and had active line of tratment.
Require your cooperation in this issue as the claim was rejected given vague reasons. I am following up this case for a month now with no peace of mind due to huge loss in money.
Was this information helpful? | 
