[Resolved]  National Insurance Company — Insurance claim rejection sighting no active line of treatment

Address:560027
Website:nationalinsuranceindia.nic.co.in

Hi,
Details of insurance:
Uhid no nic.12779109
Name suraj narayan naik
Plan period 31/05/2015 to 30/05/2016
Policy no 602100/50/15/10000369
Organisation aris global software pvt ltd

I was hospitalized between 05th march 2016 to 9th march 2016 at mysore amruthkripa hospital. And was diagnosed as enteric fever (Typhoid). And doctors started treatment still the fever was not subsiding, so asked me to visit higher hospital at bangalore. I continued the prescribed treatment of iv antibiotic. Then also the fever was not subsiding, so visited panacea hospital basaveshwara nagar, bangalore. There dr. Siddaraju told me treatment can not be outpatient. And recommended hospitalization. During hospitalization i was given many tablets and iv fluids, multivitamins through iv drips. These were symptomatic treatment. Later i was diagnosed with enteric fever with viral hepatitis. During hospitalization at panacea, me and hospital administration has contacted national insurance via email. At that time the insurance company told to submit the documents at discharge. If the insurance company physicians, they cant take such a early decision whether i should be hospitalized or not, whose fault is it. Because i am not a health professional to take a call, i believed physicians at panacea and got admitted.

Now when i submitted the documents for claims, my first hospitalization bills have been passed but the second hospitalization claims were rejected.

I have been given intravenous fluids and multivitamins through drips for constipation, which is a symptom of either the hepatitis or enteric fever. And such treatments can not be taken at home, unless i hire a certified nurse, which will cost more than the hospitalization.
Now the insurance company is saying there was no active line of treatment and the hospitalization was for evaluation.

Kindly look into it and advise me how to go about it. Meanwhile i am in touch with my lawyer and will seek his advise as well.

Claim amount: 39418 inr
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Sep 9, 2016
Complaint marked as Resolved 
National Insurance Company customer support has been notified about the posted complaint.
Verified Support
Aug 09, 2016
National Insurance Company Customer Care's response
Dear Sir, We thankfully acknowledge your grievance. Due to technical complicacy of grievance redressal, it is very difficult for us to redress grievance in this forum. You are requested to write your grievance at customer.[protected]@nic.co.in You can also directly lodge grievance at nationalinsuranceindia.nic.co.in or igms.irda.gov.in Inconvenience caused is deeply regretted.
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