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Rejection Of Medical Claim By Oriental Health Insurance

Location/place: Mumbai

Name of company/service: Service

I have a policy of Oriental Health Insurance Company.My Mother who was hospitalized on 10th Jan 2012 was discharged on 12th Jan 2012. Doctor’s diagnosed Stones in the Gallbladder and Hyper Acidity infection in her stomach.
She was for 3 days in the Hospital & bill came to around 22000/- we put a claim and was rejected. We got the rejection letter from our TPA MD India last week after logging a complain with Oriental.
They have rejected on the basis “patient was admitted for Hyperacidity it is one of the complication of Gall Bladder Stone and Policy in second year hence the claim is rejected. ”
My question is are we not eligible to claim the admission and the test cost….??????

Appreciate your help.

Thanx & Rgds
Jaison D’souza

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