[Resolved]  ICICI Prudential Life Insurance — claim rejection

Address:

Thrissur, Kerala, 680028

I had submitted a claim request for mrs. Indu. V. P on 8/9/2017 for plaster cast application below knee done on day care basis (Claim no. Cl9288181 on icici pru health saver policy no.1140180). But it was rejected citing policy terms & conditins 3. (Benefits) a. (Hospitalisation insurance benefit) a. (Hospitalisation) for less than 24 hours hospitalisation. But as per policy terms & conditions 3. (Benefits a. (Hospitalisation insurance benefits) b. (Day care procedure).'the procedure must require hospitalisation for less than 24 hours and must be on written advice of medical practitioner'. Closed reduction of fracture is included as sl. No.72 in the list of day care procedures in annexure i of policy document. So the claim may be approved.