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Claim rejection by stating pre-existing disease by medi insurance co


27-Sep-2023 (In Insurance Law)

Royalsundaram has rejected my health insurance reimbursement by stating that its a pre existing disease and forfeited my premium on grounds of non disclosure. I fight with them and ask to present me the documents which states its a pre existing disease but they are not presenting me any documents and stating that we will keep these documents for our records. Is there any obligation for insurance company to present me the proof. If i will go to court is there what documents I required. Is there any consequences for me if i file case against them. How I can send legal notice to them.

Answers (1)

Answer #1
118 votes

They must be relying on your medical prescirption which states your previous disease. 

Further more check  in your insurance policy because there must be a caping clause , which means after certain years you are eligible for claim for pre exixtence disease. 

You should send a legal notice through lawyer thereby directing them to produce the documents which states that you were suffering from pre existing disease.

If they fail to give you reply then you file a consumer case before consumer forum.

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