Cashless health insurance denial creates immediate pressure during hospitalisation. The hospital may ask the patient or family to pay the bill before discharge. The TPA or insurer may say that cashless approval is not possible due to query, incomplete documents, suspected pre-existing disease, waiting period, policy exclusion, non-disclosure allegation or [...]
Medical records are often the most important documents after hospital treatment, surgery, ICU admission, death, insurance rejection or suspected medical negligence. Without proper records, a patient or family may not be able to understand what treatment was given, why a complication occurred, whether billing was proper or whether further legal [...]
A health insurance claim may be rejected when the insurer alleges that the illness was a pre-existing disease. This is one of the most common reasons given in health insurance disputes. The policyholder may receive a rejection letter stating that the disease, symptom, treatment or condition existed before the policy [...]
A health insurance claim rejection can place a patient and family under sudden financial pressure. The policyholder may have paid premiums regularly, submitted hospital bills and followed the claim process, but the insurer may still reject the claim by referring to policy exclusions, pre-existing disease, waiting period, non-disclosure, incomplete documents [...]
A medical negligence complaint is not decided only on suspicion, pain, dissatisfaction or an unfortunate treatment result. At the same time, hospitals cannot ignore their duty to maintain and provide proper medical records. The NCDRC decision in Sanjay Gandhi Post Graduate Institute of Medical Sciences v. Rajendra Nath Keserwani & Anr. is [...]
A hospital bill may run into several pages and contain charges for consultations, procedures, medicines, consumables, investigations, equipment, nursing services, room rent and professional fees. In many cases, the patient or family pays the amount without having enough time or information to verify every entry. A high bill alone does [...]
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