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Is cancer surgey paybale in 1st year of policy?

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24 Jun, 2023 by  abilove

My policy is Oriental Health floater policy 2021. It's 2nd year policy. In end of first year diagnosed with cancer and surgery done, release from hospital in 2nd year of policy.


Oriental TPA denied my cashless saying since it s 1st year policy hence no surgery payable in first year as 2 years waiting period. After looking the policy document in point 4.2 Specified disease / procedure waiting period- code- ExcI02


in E (XIV) says: Surgery of genito-urinary system excluding malignancy (2 years waiting)


is it not saying if cancer then no waiting period? it didn't said 2 years period including malignancy or any other ailments mentioned in the list.

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11 Jul, 2023

Hello Abilove,

Typically, insurance companies provide coverage for cancer from the 31st day of policy issuance.

In your specific case, however, you will need to provide substantial proof to the insurer demonstrating that you did not have cancer at the time you purchased the policy - that it was not a pre-existing condition.

If you believe your insurer has rejected your claim on invalid grounds, you have the option to file a complaint.

We have written a detailed article that outlines the various channels through which you can file insurance-related complaints in India. You can check it out here:

How To File A Complaint Against An Insurance Company In India? | Beshak

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23 Jul, 2023
abilove
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