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Insurance company denying claim for surgery


10-Nov-2023 (In Consumer Court Law)
My brother has undergone a neurosurgery of cervical disk prolapse which was caused due to an accident at home. The Insurance company is denying the claim by saying that Cervical disc prolapse is not covered by the insurance company unless it's due to accident. Whereas it's due to an accident at home.
Answers (2)

Answer #1
609 votes
hi,
because of, from your own negligence it happened to you, (what the insurance company is presuming), and you have no proof of any accident occurred by fault of any other person, so find a solution from their own terms of policy. contest the case in a court and claim the money.

Thanks & regards
Answer #2
528 votes
The definition of accident shall be defined in the policy and incase it is not then definitely the accident at home shall be covered. you need to file a legal notice and subsequent to that file a case and for sure money can be claimed.

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