Page 2 of 2 FirstFirst 12
Results 11 to 14 of 14

Thread: Claim rejection? Knee replacement surgery

  1. #11
    PolicyWala Fan
    Join Date
    Apr 2009
    Location
    Shimla
    Posts
    54

    Default

    Quote Originally Posted by abraham View Post
    Hey all - Got a pre-auth for 2 Lacs for my Mom today. No questions asked. Had presented the facts as it is with accident details, FIR, etc ... I assume there will not be an issue now. Or is there a chance it can be cancelled at the time of surgery on any basis? Is that a possibility ?
    Are you hiding something?
    Or doing some wrong doing with the claim?

    If all OK. Then why the insurance company deny the claim.


  2. #12
    PolicyWala NewBie
    Join Date
    Apr 2012
    Location
    pune
    Posts
    6

    Default

    well, i think this forum is to clarify things from the experts. I aint hiding anything; was just asking if a claim can be denied after pre-auth? Does it happen ever? etc .... IF u read up i have already stated I went ahead with all the facts as it is .... It isnt everyday that I claim from a Medical Insurer - so asking / clarifying ...

  3. #13
    Administrator
    Join Date
    Apr 2009
    Location
    Chennai
    Posts
    255

    Default

    Quote Originally Posted by abraham View Post
    well, i think this forum is to clarify things from the experts. I aint hiding anything; was just asking if a claim can be denied after pre-auth? Does it happen ever? etc .... IF u read up i have already stated I went ahead with all the facts as it is .... It isnt everyday that I claim from a Medical Insurer - so asking / clarifying ...
    Yes, its possible that a claim can be denied after a pre-authorization. Pre-authorization is not a guarantee. Claims can only be determined eligible/ineligible at the time it is processed, and may be denied even after a pre-authorization or pre-determination is issued.
    You will pick up maximum wrong numbers when on roaming.

  4. #14
    NewBie
    Join Date
    Jun 2012
    Location
    Delhi
    Posts
    2

    Default

    Yes Abraham, It can also be cancelled after approval but I hope it would not be in your case but stick to your points, what ever you mentioned while Pre-Auth because when a surveyar will come to hospital then he/she would note down your statement. So, be careful and stick on your words but once your mother got discharge from the hospital then nothing to worry. Describe each and every point to your mother because company representative will approach to your mom


Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •