mediclaim policy coverage

You can go to Consumer Disputes Redressal Forum for the reimbursement of your expenses of 1.5 Lakhs from the Insurance Company. Under the policy, after 2 years of the policy major Diseases was covered by the Mediclaim Company, and Tumour is not a kind of disease which can be kept hidden or anyone can wait for 2 years fotr the treatement.

Hope you get your answer. Have a nice day.

First submit the entire bills demanding for immediate reimbursement.

Let them reject the bills stating the reasons.

Then issue a notice through advocate making counter that the rejection is not legally valid.

Then make a complaint to Insurance Ombudsman and IRDI

Let this process continue for 6 months without spending an additional rupees.

After six months file Consumer complaint.

All this in good faith that the pre existing condition was not suppressed and policy was taken without knowing such ailment in advance.

Has your preferred tha claim? If rejected, take up the matter with the Insurance Ombudsman. The Ombudsman can take into account equitable considerations while deciding the dispute. For the purpose of an insurance claim, a desease can be said to be contracted only when it is diagnosed by a competent physician and confirmed. 

You are required to submit your claim with relevant bills, prescripttions and discharge certificate with a copy of policy for reimbusement.

If it is declined / rejected move to consumer disputes redressal fora of jurisdiction.