Trastuzumab inj claim rejected by Insu... - Breast Cancer India

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Trastuzumab inj claim rejected by Insurance company.

Vondematharam
Vondematharam

Please provide me with orders of Insurance Ombudsman or Consumers Court regarding payment of claim in respect of Trastuzumab inj given to the CA Breast patients.

6 Replies
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Trastuzumab - was this inj given separately or along with other chemo drugs, if given separately then claim may get rejected, if given with other drugs then you are eligible for claim, just get a letter from your oncologist and submit along with the claim form, United India Insurance approved my spouse's claim for 5 injections along with chemo

Thank you very much.

roxboxfox
roxboxfoxRadiationOncologist

The Insurance company letter and their brochure of Terms and Conditions have mandatory obligation, inncase you are not happy with their decision, you can Complaint to the Ombudsman and details should be provided by the company.

Thanks sir.

Ours was a stand-alone injection which was rejected. Ombudsman passed 50% of claim amount, took about 6 months. Definitely go ahead and complain to Ombudsman.

Yes I have seen the order of Ombudsman of Maharashtra in case of one Attorney who herself was undergoing the treatment. She has appealed to the Ombudsman and in that order it is stated as 50%. But she replied to me stating that she got entire amount as thete was sufficient amount in the policy. Thanks sir.

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