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Insurance

Health insurance claim

My cataract surgery claim short closed due to the sub limit. Cataract surgery done by using advanced technology and toric lens used for medical condition. Lens cost not paid due to sub limit. Is it acceptable

( Salem, Tamil Nadu )

3 months ago

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A.
Dear Client,
The terms and conditions of an insurance policy are the most crucial and vital to go through before raising a claim against the health insurance policy. Based on the self-declaration of the policy buyer and post-medical tests of the insured, wherever required, the risk and coverage are underwritten, and the Actuaries of the Insurance Company calculate the premium following the guidelines of the regulatory authority IRDAI. If the tern of policy states that the cost of cataract surgery using advanced technology is excluded from the insurance coverage or the sub-limit, then your claim even if raised before the Consumer Forum may not yield an order in favour of you. However, get the matter once consulted and reviewed by an expert professional to understand your rights and remedies in the matter.
S. K. Dutta Advocate S. K. Dutta
S. K. Dutta
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