[Resolved]  Reliance mediclaim policy — rejection of claim on false grounds

Reliance General Insurance policy no:[protected]

after the hospitatlisation of my wife in Apr 2009, i submitted the hospital bills to Relaince TPA Medi Assist India P Ltd., New Delhi Office on 23.04.2009. After a number of visits to their office and unlimited number of telephone calls the claim was cleared from medi Assist and forwarded to Reliance General Insurance for reimbursement. Then again we started the same procedure of long telephonic conversations and discussions, after approximately 8 months in Dec 2009 we recevied a letter from MediAssist that our claim was rejected by Reliance on the ground that the said treatment did not need hospitalisation at all, while even after 1 month after discharge from the hospital my wife was not able to move normally. She was on leave for approx 40 days from her office. how could their investigator report that such treatment doesnot warrant hospitalisation and thus not fulfilling policy conditions.even if it is true, how can a reputed hospital like Fortis can admit a patient who could be treated in OPD and made a bill of Rs.40000/-plus. Either Fortis or MediAssist are to be blamed for that. why should i bear a loss of such a huge amount. Although i personally know that my wife needed hospitalisation in such conditions. i have seen that she could not even sit for 1hour at a stretch even after 2 weeks of her discharge.
Please initiate the proceeding at the earliest so that i may get the reimbursement from them, otherwise why would an ordinary person of lower middle class family take a mediclaim policy from such big companies like Reliance.
thanking you in anticipation.