Complaint Details

Status	:	Closed
Complaint No	:	0014745/2014
Category	:	Insurance
Date	:	04-02-2014
Subject Line	:	Insurer Repudiate a Claim
Complainant	:	Devendra Kumar
Address	:	TRT F-355, Block No-30, ACC COLONY, JAMUL CEMENT WORKS, BHILAI, CHATTISHGARH
Complainee	:	oriental insurance
Address	:	ORIENTAL HOUSE, 1ST FLOOR,7-J TATA ROAD, CHURCHGATE,400020

Complaint Details
Policy Number :124600/48/2014/2257
Claim Number : CCN# 2997404
My Spouse has Urine Disorder with svere knee pain with weakness and vision disturbance after OPD observation doctor advised for hospitalisation on based of complained noticed by patient and justification letter about hospitalisation also send by doctor by fax to Mediassist india pvt Limited. so dignosis are related with dieses I have also evidence of abnormality on that time such as CRP on that period noted abnormal. sweling also found in knee urine infection also find out by the dignosis and line treatement also provided by the hospital during hospitalisation such painkillers and antibiotic than how it will become under your Claim is not payable vide exclusion no.4.10 which is as under:- "Expenses incurred at Hospital or Nursing Home primarily for evaluation/ diagnostic purposes which is not followed by active treatment for the ailment during the hospitalised period."

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