sujith.padmanabhan
New member
- Policy Name
- 31-25-0085063-00
- Company Name
- Aditya Birla Health Insurance Co. Limited.
- Customer Care Number
- 18002707000
- Loss Amount
- 178071
- Ratings
- Opposite Party Address
- 9TH FLOOR, ONE WORLD CENTRE, TOWER-1, JUPITER MILL COMPOUND, 841, Senapati Bapat Marg, ELPHINSTONE ROAD, Mumbai, IN-MH, 400013
Dear Insurance Ombudsman,
I am writing to seek your intervention regarding the rejection of my Father's health insurance claim and the subsequent rejection of the grievance by Aditya Birla Health Insurance Co. Limited.
Policy Details:
Policy Number: 31-25-0085063-00 (31.05.2025)
Claim Number: 1122685076414 & 1122685117430
Insured Person: Padmanabhan K V
Date of Claim Submission: 16.02.2026 & 08.03.2026
Background:
I submitted the claims on-beahalf of my Fathe, claim number 1122685076414 & 1122685117430 to Aditya Birla Health Insurance Co. Limited on 16.02.2026 & 08.03.2026 respectively for his past treatment (hospitalization) and on-going treatment of Multiple focal lesion liver (cancer). The claim was rejected on 16.03.2026 & 17.03.2026 citing the patient has a history of Bronchiectasis since 2023 which falls pre-existing to policy inception and was not disclosed.
However, I would like to respectfully contest this decision and would like to clarify that my Father have never been diagnosed with bronchiectasis prior to this hospitalization, nor have I undergone any treatment or taken any medication for this condition in the past. Therefore, we did not list it as a pre-existing disease when obtaining the policy.
Believing the rejection to be unjustified, I submitted a formal grievance to the insurer on 09.04.2016. After reviewing my grievance, the insurer communicated its final decision with the same reason , maintaining the rejection of my claim.
I respectfully submit that:
The claim was filed in accordance with the policy terms and conditions.
All required documents and information were provided to the insurer.
The reasons provided for rejection are inconsistent with the policy coverage and/or the facts of the case.
I requested Ombudsman to review the matter to provide appropriate relief by directing the insurer to reconsider and settle the claim as per the policy provisions. Unfortunatly, I haven't received any response from them even after multiple followup emails.
Since the claims were rejected, My Father and also a sinior citizen, not able process the on-going treatment claims and facing difficulties with his treatment financially.
I would be grateful for your assistance in resolving this matter. Please let me know if any additional information or documentation is required.
Thank you for your time and consideration.
Regards,
On-behalf of K.V. Padmanabhan
Suijth K P
I am writing to seek your intervention regarding the rejection of my Father's health insurance claim and the subsequent rejection of the grievance by Aditya Birla Health Insurance Co. Limited.
Policy Details:
Policy Number: 31-25-0085063-00 (31.05.2025)
Claim Number: 1122685076414 & 1122685117430
Insured Person: Padmanabhan K V
Date of Claim Submission: 16.02.2026 & 08.03.2026
Background:
I submitted the claims on-beahalf of my Fathe, claim number 1122685076414 & 1122685117430 to Aditya Birla Health Insurance Co. Limited on 16.02.2026 & 08.03.2026 respectively for his past treatment (hospitalization) and on-going treatment of Multiple focal lesion liver (cancer). The claim was rejected on 16.03.2026 & 17.03.2026 citing the patient has a history of Bronchiectasis since 2023 which falls pre-existing to policy inception and was not disclosed.
However, I would like to respectfully contest this decision and would like to clarify that my Father have never been diagnosed with bronchiectasis prior to this hospitalization, nor have I undergone any treatment or taken any medication for this condition in the past. Therefore, we did not list it as a pre-existing disease when obtaining the policy.
Believing the rejection to be unjustified, I submitted a formal grievance to the insurer on 09.04.2016. After reviewing my grievance, the insurer communicated its final decision with the same reason , maintaining the rejection of my claim.
I respectfully submit that:
The claim was filed in accordance with the policy terms and conditions.
All required documents and information were provided to the insurer.
The reasons provided for rejection are inconsistent with the policy coverage and/or the facts of the case.
I requested Ombudsman to review the matter to provide appropriate relief by directing the insurer to reconsider and settle the claim as per the policy provisions. Unfortunatly, I haven't received any response from them even after multiple followup emails.
Since the claims were rejected, My Father and also a sinior citizen, not able process the on-going treatment claims and facing difficulties with his treatment financially.
I would be grateful for your assistance in resolving this matter. Please let me know if any additional information or documentation is required.
Thank you for your time and consideration.
Regards,
On-behalf of K.V. Padmanabhan
Suijth K P