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Covid cocktail claim rejection

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07 Jan, 2022 by  shreyas

Insurers are rejection covid antibody claim citing that it is not prescribed by icmr. However doctor should decide line of treatment based on patient requirements and insurance company cannot decide appropriate treatment. What

Pleas can be taken against this unfair rejection. Asking for multiple family members claims as all had co morbidities



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Health Insurance

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09 Jan, 2022

Dear Shreyas

Anti body treatment is advised in mild cases who are not hospitalised.

That is the reason , insurers would reject such cases .

However , if Doctors have adised this treatment for an in hospital treatment under sepecific reason then Claim can be fought .

However as standard practice , insurer are right in rejecting the claim because hospitalisation was not required .

Hope this clarifies

Shailesh

Insurance Samadhan

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10 Jan, 2022

Hello Shreyas,


Can you please elaborate on what do you mean by COVID antibody claim?


If you are talking about COVID antibody treatments, please clarify if the treatment was prescribed as part of a hospitalization? Was the treatment for prevention or for cure of a health condition caused due to COVID?


Regards,

Beshak




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10 Jan, 2022
shreyas
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19 Jan, 2022
Avinash Sonee

Hi,


Each insurer might process the claim differently.


For one of our customers who has undergone hospitalization for cocktail administration, HDFC Ergo has approved the claim. Age: 35y with no PED


For a similar case of another customer, claim has been submitted in Star Health, waiting for the claim processing to complete. Age: 58 with Hypertension as PED.


Both are reimbursement claims.


Thank you

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21 Jan, 2022
shreyas
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