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Medi Assist India — Claim number 13753064 rejected

Hi,

My father has been a diabetic patient for the past 8 years. He was admitted for treatment of diabetic odema which is a result of diabetic liver decomposition and not alcoholic liver disease.

Further, my father has never had a alcoholic history. He has quit alcohol 16 years back. Even the discharge summary of Poona hospital does not mention the primary reason of liver decomposition to be alcohol abuse.

This is a clear case of denying the claim for frivolous reason.

I request you please look into this matter immediatly, or else I will have to go to the consumer court and file a complaint for wrongly denying my claim.

Thanks,
Sumeet Chavan
Assistant Operations Manager Legal
JPMC
On 19-Jan-2017 1:00 PM, Team Medimanage wrote:
New reply for the ticket #MM00130984

Hi Sumeet,

We regret to inform you that, your reimbursement claim is processed and denied. Please find the denail reason below for your reference.

On persual of Policy document it has been noted that the claim pertains to a person 65yrs old hospitalised for Anasarca in Decompensated Alcoholic Liver Disease. And as per policy terms and conditions use of intoxicating drugs/alcohol not covered.hence we are unable to consider the case.The claim stands denied.

#MM00130984

Thanks & Regards,
Team Medimanage

Last Contact Reply
From: Query
Date: Wed, Jan 18, 2017 at 08:52 PM

Hi,

I have submitted a reimbursement claim on 22/11/2016 and I have received SMS confirmation that the claim is registered with # 13753064.

This claim is not showing on my active reimbursement claims dashboard, hence I am also not able to check the claim status.

Request you to kindly address this.
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Complaint Status


[Jan 19, 2017] Medi Assist India customer support has been notified about the posted complaint.
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