Mdindia Health Insurance Tpa Private Limited — insurance company claim number:- [protected]c[protected]

Address:	577301
Website:	mdindiaonline.com

Policy details :
Uiic under written sail corporate policy [ steel authority of india ltd. ]

Employee name : rudrachari k

Employee code : 13802838

Policy period : 11-apr-2018 to 10-apr-2019

Policy coverage/inception dt. : 11-apr-2018

Sum insured : 400000 - cb amt. 0 [ applicable si : 400000 ]

Doa : 29-apr-2018 to 21-may-2018

Diagnosis : [ surgical ] close right distal humerus communited intra-articular fracture, dm, htn

Claim status :

1. The requested amount inr 140756

2. Claim type - reconsideration

3. Status - pending for additional document request from insured/patient

4. For the liability amt. 140756

Wrt to the above claim number, md india had requested us to provide an additional document explaining reason for delay in letting them know when patient has been admitted to hospital.

We have provided additional documentation for the same in the form of an email attaching a duly signed copy of the letter, despite which claim has been rejected stating the following reasons:

Date of repudiation: 17/12/2018

Reason
1. 1. The claim is closed, as requisite documents are not provided in despite of additional document request letter dated — and —
2. The available information from the documents does not satisfy for the eligibility of the claim. We had requested the following documents. Insurance company approval for claim intimation delay condonation.
3. Till date we have not yet received the above documents which are mandatory to decide the eligibility of the claim. So we wish to close the claim on the ground of non-compliance of required documents.