Dear sir,
I am taking medi claim of United India via Unique Mercantile india pvt. ltd. for 12 years, United India & Uniqe are associate for the medicalim policy. for 12 year my policy is regular, i have taken claim only once before 5 years. Recently i put a claim for hospitalization and follow the whole procedure, i have submitted all the documents including 12 years mediclaim certi copies, there is never skip in premium or delay in renewal. they denied the claim for following reasons
1. Policy coverage is for 1 Year/Years.
2. Inception date of policy is 31-Mar
3. Current policy is in First Year/Years.
4. Current illness is a complication of ABDOMINAL PAIN K/C/O DM TYPE II which is since 8-10 Years as per MMR Form
5. Pateint admitted for ABDOMINAL PAIN K/C/O DM TYPE II, manage conservatively, policy in 1 st yr. Hence the illness has occured prior to inception of policy (Pre-Existing to policy inception date). As per policy terms and condition pre existing diseases not payble. Hence claim not payble.
6. As per Policy terms and conditions, claim is not payable, Under Clause No. 4.1 (Please refer to policy copy for details)
i have acknowledgment of submission of docket of 44 pages.
pl. guide me for the further action
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