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[Resolved]  The New India Assurance Company Limited — regarding rejection of mediclaim case - the case of genetic disorders & stem cell implantation / surgery not covered under mediclaim policy

Sub : claim file no.[protected] patient : krishna rathwa under policy
No.[protected]

R/sir, madam

With ref. To above subject & policy no., i have whole family mediclaim policy. I have applied mediclaim case to company as my daughter krishna rathwa was admitted in hospital. The new india assurance has rejected the mediclaim case in respect of krishna rathwa mentioning that the case of genetic disorders & stem cell implantation / surgery not covered under this policy as per terms & condition clause no. 4.4.16.

Respected sir, it is my worthless for me paying of premium about 20, 000/ per year as this policy which is not covered such treatment.

So, it is my kind request to look into further / re-open the case & kindly settle the case at your end at an earliest please.
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Jun 17, 2019
Complaint marked as Resolved 
As per Letter received from New India Assurance mentioning that we are in receipt of your claim document No.9091819329126, as per available details the patient ( Krishna Rathwa) was admitted for SEVER ANEMIA, SICKEL CELL ANEMIA SICKLING TEST POSITIVE WITH SUP ADDED INFECTION & CRISES & treated for the same . As per New India Floater Mediclaim policy terms & conditions clause no. 4.4.16, Genetic disorders and stem cell implantation / surgery - the Claim stands non payable. This is for kind information & do needful action at your end please. Thanking you. (S T Rathwa)
May 02, 2019

Complaint Status

New India Assurance customer support has been notified about the posted complaint.
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Comments

My mediclaim pol no is[protected] . I have submitted claim vide cc no MDI 4790615.since one month and more, instead of processing claim in stipulated time tpa is repeatedly advising me wait for 07 days for completing the processing.

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