Oriental Insurance Company — wrong resolution for rejection of claim

Address:	400097
Website:	Mediassist tpa and orintal insurance

From,
Kirtibhai m shah
Residence-malad-e (Mumbai)
Policy no-131102/48/2018/1786
Dated: 1st december, 2017
To,
The oriental insurance co. Ltd.
No.8, vishva vinay bldg,
Behind johnso, bhagoji, keer marg,
Mahim-400016
Subject: declining your “denial letter” & reason of claim given by oriental insurance co. Ltd.

Details:
Claim no[protected]
Policy no: 131102/48/2018/1786
Patient name: kirtibhai mafatlal shah
Policy holder name: maltiben kirtibhai shah
Maid: 272577

Dear sir,
My self kirti m shah from mumbai received your denial letter of dated 13.11.2017.in above policy, given reason is not acceptable against claim.
1) as given hyper tension reason, was only the history which was occurred 20years before for which no further treatment is going on. Also, there is no link between hyper tension with current diagnose diseases i. E. Angiography & angioplasty as per doctor’s clarification.
2) if you have any evidence regarding current diagnoses is link with hyper tension, please provide the same. Although as per doctor’s concern there is no link between it.
3) if you require any clarification regarding this claim from the doctor please raise the clarification letter address to doctor with details. This we can provide you for your query.
4) as per doctor’s clarification with us there is nothing to do with current diseases. He is agreed to give clarification if you ask for the same.

We are waiting for your positive reply & if you want any further clarification we will like to provide the same.
Request you to resolve the issue as early as possible.in any case if we are not satisfied with your reason of deny the claim; the same will be escalating to higher authority.

Regards,
Kirti m shah

Note: please find enclosed documents,
1) policy document
2) denial letter
3) discharge summary