[Resolved]  Royal Sundaram Health Shield Insurance — MEDICLAIM DENIED

I Had taken Royal Sundaram Health Shield Insurance on 31.12.08 under policy No. HL[protected]-X001 covered my family consisting wife and 2 kids for Rs. 1 lac for each head.

On 2nd june, 09 my son AKHIL RAJ went to ENT OPD with complaint of decreased hearing. while examining the ears, Dr. Hemant Chopra found his right ear drum damaged and advised a surgery called TYMPANOPLSTY and left ear GROMMET INSERTION. it was school vacation time, we decided to get the surgery done immediately becos during summer vacation, the child can get complete rest. Fortunately the next theatre day Dr Chopra's has time to perform the operation also. so we admitted him to DAYANAND MEDICAL COLLEGE, Ludhiana on 3rd june itself and surgery performed.

when admitted, i contacted DMC corporate cell with my mediclaim card, and register the case with them. however, till the discharge date of 6th june, my case has not been approved by the insurance company for cashless policy. then i submitted original bills and complete papers for reimbursement of expenses but after continous follow up, the case has been denied with reason "THE DESEAS IS CHRONIC AND PRE-EXISTING whereas the doctor clearly mentioned it was not any previous symptoms.

My family was protected with Mediclaim for the last 4 years with another company and if my son is having this deseas, i might had been operated him under medicalim with Park. why should i wait till date since i dont have any difference if it is ROYAL SUNDARAM OR PARK. i could only knew his ailment now and that too we noticed when he was not responding to small voices. if any othe symptoms, then we can understand it.

so the rejection of my son case is totally illegal and i seek help and assistance.