| Address: H.No. 3447 Ground Floor , Sector-23 D,Chandigarh |
| Website: Claim Denial f |
Dear Sir/Madam,
I am requesting you formally for reconsideration of the reimbursement denial for Claim ID 2656637, pertaining to the medical treatment of my dependent, Vishal, under Policy Number [protected].
The delay in filing this claim with Niva Bupa was due to a prior submission process with my employer-sponsored group insurance. Please find the chronological details justifying the timeline of this request:
1. Initial Submission (Primary Insurer): I initially submitted the claim to my employer’s insurer, Bajaj Allianz General Insurance (TPA: Medi Assist; Policy: OG[protected]-[protected], as the hospital (Kular Hospital, Bija Khanna) did not have a cashless tie-up. The total claim involved ₹15, 000 for pre-hospitalisation and ₹550000 for the surgery. And post-hospitalisation is still pending for submission. ( Fact is attached/Data attached) Total Amount is Rs 590000approx.
2. Notification of Denial: On January 28, 2026, I was officially notified by Bajaj Allianz that this “specific ailment is covered exclusively for employees and does not extend to dependents”. I have attached the official denial email for your verification. ( All evidence available)
3. Immediate Action with Niva Bupa: Upon receiving the denial from my primary insurer, I immediately initiated the reimbursement process with Niva Bupa on January 30, 2026.
The delay was not due to genune resion, but rather the time required to exhaust the primary insurance claim process provided by my employer. Given these facts, I kindly request that you to waive the submission delay and process the claim on its merits.
I have attached all relevant medical documents, the Bajaj Allianz denial letter, and the pre/post-hospitalization records for your review.
Please feel free to contact me at [protected] should you require any further clarification or additional documentation.
Thank you.
Best regards,
Vishal Saxena.
[protected]
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