Complaint Details

Status	:	Closed
Complaint No	:	0003460/2013
Category	:	Insurance
Date	:	26-02-2013
Subject Line	:	denying of medical insurance cliam
Complainant	:	Binay Kumar Jalan
Address	:	55/7,sora hunse main road, varthur bangalore
Complainee	:	Royal sundaram alliance insurance company limited
Address	:

Complaint Details
I have a mediclaim policy bearing no> HMA0028324000100 . from royal sundaram. Now coming to the incident i was suffering from loose motion and womitting issues on jan 12th i consulted the doctor he gave me medicines but was not able to control the same ,So finally i was admitted on 13th jan 13 and was given treatment in the hospital .After getting discharged i submitted the claim on jan 24th which was received by them on jan 29th.Later i got a verification call from a doctor of the insurance company i told the things in detail to him finally On 23rd feb i received a letter Stating as under<

The claim documents has been persued our claim panel and we observe that the insured was hpspitalized for Acute Gastroenterits .As per medical opinion,the treatement rendered during hospitalization does not warrent hospitalization and can be done as an Out Patient Procedure.
Hence we regret our inabiulity to consider your claim on the above grounds.
Now Please let me know two things 1) Whether i was admittedf to hospital simply that in an emergency morning 5am.
2) does i mediclaim policy says a patient suffuring from Acute Gastroenterits will not be covered .

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