Oriental Insurance Company — Refusal of Claim against Policy Number - 261600/48/2014/2598

Address:

Sonipat, Haryana

Dear Sir, Policy Number: 261600/48/2014/2598 Policy: PNB-ORIENTAL ROYAL MEDICLAIM POLICY Insured's Name: MRS. ISHWAR DEVI W/O SH. SANTLAL. Claim Number: 10942978 Claim Amount: Rs. 49964 My Mother was hospitalized on 26 Feb 2015 for female gentle prolapse and discharged on 03 March 2015 and I had submitted all the original medical bills and necessary supporting documents to the TPA for mediclaim. After submission, I got the Intimation of the refusal of the Claim citing some policy terms and conditions. This was not a planned surgery as we came to know about this unfortunate disease last month only and doctor advised for immediate surgery. At the time of the policy purchase, no one has told us such terms and conditions, instead we were told that all diseases will be covered. We are having medical cover for such unforeseen medical problems, if such problems are not covered then for what we are paying premium every year. Besides, my mother was insured under the Oriental Insurance family floater Policy No: 261600/48/2013/1599 in FY[protected] as well. After my marriage we decided to buy separate policy for them. I request you to review my mother case and consider it for your kind approval.