Dated: 18-Dec-2020

LAKKIMSETTY DHANISH KUMAR

8-2-326/4/4, ROAD NO.3, BANJARA HILLS, HYDERABAD
HYDERABAD, HYDERABAD
TELANGANA, 500034

Dear Sir/Madam,
Subject: Claim Repudiation letter
This is in reference to given below claim reported by you.

Claim No : 202200056770 Policy No : 180132028430000048

Name of the Patient : LAKKIMSETTY PANVITH Policy Validity : 04 Jul 2020 to 03 Jul 2021
Hospital : RAINBOW CHILDRENS HOSPITAL DOA : 21 Nov 2020
Ailment : CORONAL HYPOSPADIAS
Claimed Amount : 179681.00 DOD : 21 Nov 2020

We have evaluated the claim based on the supporting documents submitted by your good self. On careful perusal of the claim documents, we regret to
inform you that we are unable to admit the liability of your claim due to the reasons mentioned herein below:
1. - Member reimbursement cannot be considered as per received documents of Master Panvith Lakkimsetty admitted in Rainbow Children Hospital from
DOA- 21/11/2020 to DOD- 23/11/2020 with abnormal position of urethral opening and found to have coronal hypospadias. During hospitalization underwent
single stage urethroplasty- Snodgrass repair. As per policy T&C congenital external is not covered- Infertility / Obesity / Congenital External / Veneral
disease / Alcohol, intoxicating drugs, Drug abuse / general debility / intentional self injury. Hence we regret to inform you that the claim is repudiated.
The above claim reported by you is not admissible as per the terms and conditions of the policy. Hence we are unable to reimburse/admit any amount
under the captioned claim. We have retained the photocopy of the claim documents for future reference.
However, if you are not satisfied with the rejection, you may approach the Grievance Cell of the RGICL as stated below step-wise:
Step 1: Write to e-mail: rgicl.rcarehealth@relianceada.com
Step 2: If you are not satisfied with the response you got, please email - Nodal Officer at rgicl.grievances@relianceada.com
Step 3: If even this leaves you unsatisfied, please email - Head Grievances at rgicl.headgrievances@relianceada.com
Step 4: If after having followed Step 1, 2 and 3 your issue remains unresolved, you may approach the Insurance Ombudsman for Redressal. The list of the
Insurance Ombudsman is available in the policy wording; Reliance Website: www.reliancegeneral.co.in and IRDAI website.
Please quote Claim No.: 202200056770 in all your future correspondence.
Yours Sincerely,
Team RCare Health
Reliance General Insurance Co. Ltd.

Important Note: This is an electronically generated document and requires no seal / stamp.
Contact Details:
Reliance General Insurance, Email: rgicl.rcarehealth@relianceada.com
RCare Health, Chat@Website: https://www.reliancegeneral.co.in/Insurance
No.1-89/3/B/40 to 42/KS/301, 3rd floor, /Home.aspx>>Chat
Krishe Block, Krishe Sapphire, Madhapur,
Hyderabad-Telangana-500081