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My wife client rejected

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22 Nov, 2022 by  Gurvinder Singh

my wife claim rejected with below reason

The claim documents and additional inputs available were reviewed by our Medical panel who have noted that the condition of the Insured patient was stable at the time of admission and throughout the period of Hospitalization. The Panel is , therefore, of the opinion that the treatment for the condition as an inpatient in a Hospital was not medically necessary and that the condition could have been managed as an outpatient without Hospitalization . Therefore, the repudiation of the claim has been found to be in order. 


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24 Nov, 2022
MBA | 5 years experience
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Dear Gurvinder,


Further detail would be required to understand reason of hospitalization, cashless or reimbursement etc before any feedback could be offered.

From your query it seems the claim has been repudiated as the insurer did not think hospitalization was necessary.


Regards

Rohit Dhingra

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