Unison Insurance — health insurance claim rejection and stating improper reasons

Website: unisoninsurance.net

Myself Samjith Raj CP, working as AI Team Manager in Detect Technologies, Chennai. I usually add my parents under my office health insurance policy by paying extra premium. Following this since I started my corporate life.

My Dad was diagnosed with Tumor on 2023 February. As a part of the treatment, My dad has to visit hospital on every month where Doctor suggest one injection in the day care, blood tests, scans etc and medicine for one month.

During the disease diagnosed period, I was having Kotak Mahindra health insurance (OnsurityMediassistKotak Mahindra insurance), where a company called Onsurity used to communicate with me to send the claim to the MediassitKotak Mahindra health insurance. I used to get most of the claims cashless, only few were rejected, even those were claimed easily through post hospitalization.

In 2024 May, my company changed the insurance provider. (unisoninsuranceMediassistNational insurance) to National Insurance. Where a company called Unisoninsurance communicate with me and send the claim to the insurance company, they are continuously rejecting my claim.

Unisoninsurance team is stating that `Zoledronic acid injection falls under OPD (Outpatient treatment). We regret to inform OPD treatments are not covered under standard GMC policy.). `
I totally agrre to this, but i have requested claim for injection + 1 month medicine bills + Blood tests etc. Where the injection only costs only 480 rupees, and other remaining amount should be covered under the claim since its not under OPD, But they are not responding properly and rejecting the claim continously.
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