[Resolved]  National Insurance Company — Claim deferred, denied and got after a lot of effort

Address: 560100

Website: niconline.in

Hi,
I applied for cashless claim 12250636 for my Father's eye surgery. I had to call the help desk again & again but couldn't get the claim. We were told that for cashless we have to wait till the end of the day in the hospital till any response comes from the insurance company.
I waited along with my father till the hospital was about to get closed. Then I had to do all the paperwork again to change the claim type from cashless to reimbursement, as the claim didn't get process till the end of day.

In reimbursement, The claim 12280942 was kept on hold after more than 1.5 months even after repeated followup. Then it was denied by giving a reason I couldnt find in the policy document.

Then when I informed that I have read the policy documents & couldnt find the clause specified in the denail reason, I was again asked to wait.

Finally I went to the escalation authority, the claim was reprocessed again as claim no[protected] & after more than 2 months after wasting a lot of my time and labour, I got the amount .
Had I not read the policy documents carefully, followed up repeatedly, my claim would have got rejected for sure. In the midst of all this a lot of my time got wasted unnecessarily . I have all the email communications with me. i am attaching the screenshots of the earlier neglected & denied claims .