Answers to the most common questions about insurance claim rejections, disputes, and the consultancy process.
Yes, depending on the reason for rejection and supporting documentation. Many rejections can be successfully challenged through a representation letter, appeal to the insurer, or complaint to the Insurance Ombudsman or IRDAI. Time limit is typically within one year of the insurer's final decision.
No. Claim decisions are taken solely by the insurance company or TPA based on policy terms, submitted documentation, and applicable regulations. We provide professional consultancy to present the strongest possible case for fair assessment — but we do not guarantee any specific outcome.
Yes. We assist in understanding denial reasons, identifying documentation gaps, and preparing supporting documentation for reconsideration. Many cashless denials can be converted to reimbursement claims even after discharge.
If your policy has a room rent limit (e.g. 1% of sum insured per day) and you choose a higher-category room, the insurer may proportionately reduce all related charges. We review if this deduction was correctly applied and challenge it where it was not.
The Insurance Ombudsman is a free, quasi-judicial dispute resolution authority. You can approach the ombudsman if the insurer has rejected your complaint or not responded within 30 days. We assist in drafting and filing the ombudsman complaint.
Yes, services are available pan India through WhatsApp, email, and video consultation. Physical consultations available in Mumbai and Maharashtra.
Policy copy/e-card, rejection or query letter from insurer/TPA, discharge summary, hospital bills, and claim correspondence. Additional documents depend on the claim type.
WhatsApp or call +91 88281 22157, email bharat@saarthihealth.co.in for claim matters, or contact@saarthihealth.co.in for general queries. Available Monday to Saturday, 10:00 AM to 7:00 PM.
Hospital Cash is a daily cash benefit paid per day of hospitalization, regardless of actual medical expenses — typically ₹500–₹5,000 per day. Many policyholders are unaware this benefit exists in their policy. We check and help claim it.
We provide claim consultancy, documentation guidance, and grievance assistance. Court representation, if required, may involve separate legal professionals. We can provide referrals if needed.