Incorrect Deductions for Health Claim
In a recent planned hospitalization for kidney stone removal, I had got pre Authorization for the same in advance from my insurance company - ICICI. The estimates shared from the hospital included all the break-up, Surgeon kee, OT fee, Laser Fee etc. The pre-authorization approved the same & mentioned deduction as only consumables & TPA fee.
At the time of the cashless bill settlement, they rejected the laser amount stating it is not included in the policy, which was around 40% of the total bill. Couple of questions -
1. If this was not included, shouldn't they mention it clearly in the pre-auth.
2. I went through the detailed policy document, couldn't find RIRS(Laser) anywhere in the exclusions.
The company is not sharing any explanation. What could be done?