National Insurance Company — no response after document submission on claim

Address:

mundakkalveedu, Thiruvananthapuram, Kerala, 695103

I am writing to complain about my father insurance claim being rejected.

My father had a surgery on left urs during the time he undergone for high grade fever treatment also. After that we got final bill with amount 155370/-. Only 30000/- is got as part of cashless claim.

I have submitted post hospitalization claim on[protected]. Claim is denied by mentioning ‘excess of ailment cappinf’. But i have clearly mentioned all the medical treatment details with this claim.

I have just received a letter informing me that my insurance policy will not cover my father’s surgery with below reason-
“the claim pertains to expenses incurred for the treatment of left ureteric calculus. On scrutiny of papers it is observed that the sub limit of sum insured is exhausted under the present policy. Hence the claim stands repudiated under the condition 3.36 of the policy.”

During the treatment on kidney stone, my father had treatment for high grade fever also.
Those medical details are already shared with insurance company.
But still insurance company is not responding on this.

I am attaching the medical details with this mail. I request that you review this case.