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Complaint #8257 — Usha Taneja

Filed: 8 Nov 2014  ·  Address: 1392, DR Mukherji Nagar,C/O Sh. Satpal Taneja
I am the policy holder of oriental insurance, TPA(Medi Assist), My insurance id is 5009973630.My policy was in effect from 22, June 2013. The hospital pa number is 9563423. There was duct carcinoma was detected in my right breast in the first week of September,2013. It was the first stage of carcinoma as per doctors and breast lumpectomy was to be done immediately per doctors. My surgery was done on 15th November 2013 in BLK Hospital. It was already approved once by Medi Assist on 25th, Jan 2014 Now that cancer has spread to my Liver and I need chemotherapy urgently to stop this spreading to other parts of body and now Medi assist is sending denial on the ground of pre existing disease. I am an ordinary housewife with 65 yrs of age and it's very difficult for me to arrange such a big amount for chemotherapy. It was detected in Sep 2013 and the policy started on 22 June, 2013 then in what way it is pre existing ? Please do the justification to my claim.

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