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Pregnancy cover Claim - UTI post pregnancy Claim denied

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28 Jun, 2021 by  Ankur Dassani

I have medical insurance from MAX BUPA for more than 8 years now.

We took a pregnancy delivery claim - which had a cap of 40k this year on 1st Jan'21.

A couple of days later my wife had to be admitted in emergency due to severe fever/shivering to Max hospital GGN.

she had severe sepsis attack during her stay at hospital and was moved to ICU, problem was later diagnosed as UTI and later discharged after 5 days of hospital stay away from the new born.


we were denied any claim saying this is linked to pregnancy - so your limit on that is only 40k.

The hospital for these 5 days charges me almost 2.35 Lacs.


When we raised this issue to the senior's in Delhi - they have reverted that we stand by our decision.


SEEK SOME EXPERT HELP IN THIS as it is a huge cost and the medical insurance should have covered this cost - whilst we have been paying premium for over 9 years now.



Regards,


Ankur


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28 Jun, 2021

Hi Ankur,


This will require a closer look into all claims papers including hospital discharge summary, indoor case papers, claim rejection letter, etc. Please e-mail your documents to Anuj Jindal at anuj@sureclaim.in. Anuj is a fellow contributor to this forum & he also runs a claims consultancy firm by the name SURE CLAIM. He could be helpful to you.


Good Luck!


Asad Akbar

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