Niva Bupa Insurance Company — Cashless request rejected by NIVABUPA for accident case ID 809582

My husband got accident (bike skid happened) due to sudden stoppage of front vehicles. He got injury at knee and after doctor’s examination, doctor recommended to stay on immobilser at least for 3 weeks. At the end of 3rd week, there was no improvement in knee pain and my husband was not able to walk. Hence, doctor suggested to go for 2nd doctor opinion and 2nd doctor recommended for ligament surgery. I am having NIVABUPA ReAssure policy ([protected]) and I have raised request (ID 809582) for cashless transactions. NIVABUPA team rejected my request initially mentioning that that I need complete waiting period of 24 months. In same clause, it is also mentioned that this clause excluded for accident case. 2nd time they have rejected that it is not accident case and asked me to submit the Medico-Legal Report if it is accident case. Hence, I have admitted my husband in hospital and submitted the MLR report as requested by NIVABUPA team. After discussing with team, they said that they are doing internal investigations and will revert by 24 hours. After that again NIVABUPA rejected the case mentioning that the incident happened on 2nd Jan 24 and MLR report is dated 20.01.24. If doctor recommended for surgery on the day of incident, definitely I would have opted for it. All the procedures followed by me as per doctors recommendation. But NIVABUPA Medical team is rejecting the request. Every time when I put up the case, new reasons are been given by NIVABUPA. Till now I did not get the approval for cashless request and I have admitted my husband in hospital for surgery and because NIVABUPA, we are still struggling. While issuing the policy, NIVABUPA team spoke very sweet words and now they are making to struggle.