Health Insurance Claim Regarding Baby

12 Aug, 2021 | by mehul

I Have a Query regarding New Born Baby Claim (age 4months).

New Born Baby was added in the Policy on 12/07/2021 and Couple Detected Baby is having ventricular septal defect and procedure was Done VSD Closure on 02/08/2021 and Discharge on 10/08/2021 and surgery cost them around 4lacs Rupees.

They are having the Policy in HDFC Ergo Optima Restore.

Can they Submit the Claim file for Reimbursement. Please give Suggestion regarding the same.

Health Insurance

Claim

Opinion

1 Answer

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12 Aug, 2021

Anuj Jindal

Co-founder, SureClaim

Hey Mehul,

This is a congenital problem, or birth defect. Insurance policy does not cover such treatments. This claim is not payable.

Anuj

3 Comments

12 Aug, 2021

mehul

Is there any Chances of Policy getting Cancelled ?

or they don't disclose about the birth defect in the Policy.

Baby name has been Added in the Policy as she was 90 days above.

13 Aug, 2021

Anuj Jindal

Co-founder, SureClaim

Mehul,

I re-checked the dates. I think I need to see the discharge summary. Could you email it to me on anuj@sureclaim.in please. I think that may change my assessment.

Anuj

14 Aug, 2021

mehul

I have Mailed you the Discharge Summary on the given Mail. Please check it and revert please.

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Health Insurance Claim Regarding Baby

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