Mediclaim
Querist :
Anonymous
(Querist) 30 July 2011
This query is : Resolved
Good day,
I have been recently operated upon due - Cystectomy and an endometriotic condition which was also causing an infertility issue as diagnosed during the pre-hospitalisation period.
I am medically covered through my employers for a S.I of INR 3 Lacs and my hospitalisation expenses was INR 98000.
My claim was recently refused sighting that the treatment was related to infertility.
I have a history of endometriosis and cysts and in the past have been operated upon once for the cystectomic condition while I was still single.
This time the cyst was detected earlier on during sonography and the endometriotic growth was also cause for concern.
The condition would anyway merit an operation. Is the insurance conmpany justified in refuting the claim just because it was done in connection with an infertile condition?????
Devajyoti Barman
(Expert) 30 July 2011
What was exactly the ground of repudiation?
Unless the Policy makes exemption for such diseases, it can not do so.
Preexisting desease is also not a ground for repudiation of claim.
