Common use of Company’s Rejection Clause in Contracts

Company’s Rejection. If the Company does not authorize the Cashless Facility due to insufficient Sum Insured or insufficient information provided to the Company to determine the admissibility of the Claim, then payment for such treatment will have to be made by the Policyholder / Insured Person to the Network Provider, following which a Claim for reimbursement may be made to the Company which shall be considered subject to the Insured Person’s Policy limits and relevant conditions. Please note that rejection of a Pre-authorization request is in no way construed as rejection of coverage or treatment. The Insured Person can proceed with the treatment, settle the hospital bills and submit the claim for a possible reimbursement.

Appears in 4 contracts

Samples: old.irdai.gov.in, policyholder.gov.in, www.irdai.gov.in

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Company’s Rejection. If the Company does not authorize the Cashless Facility due to insufficient Sum Insured Coverage Amount or insufficient information provided to the Company to determine the admissibility of the Claim, then payment for such treatment will have to be made by the Policyholder / Insured Person Member to the Network Provider, following which a Claim for reimbursement may be made to the Company which shall be considered subject to the Insured PersonMember’s Policy limits and relevant conditions. Please note that rejection of a Pre-authorization request is in no way construed as rejection of coverage or treatment. The Insured Person Member can proceed with the treatment, settle the hospital bills and submit the claim for a possible reimbursement.

Appears in 2 contracts

Samples: policyholder.gov.in, www.irdai.gov.in

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Company’s Rejection. If the Company does not authorize the Cashless Facility due to insufficient Sum Insured or insufficient information provided to the Company to determine the admissibility of the Claim, then payment for such treatment will have to be made by the Policyholder / Insured Person to the Network Provider, following which a Claim for reimbursement may be made to the Company which shall be considered subject to the Insured Person’s Policy limits and relevant conditions. Please note that rejection of a Pre-Pre- authorization request is in no way construed as rejection of coverage or treatment. The Insured Person can proceed with the treatment, settle the hospital bills and submit the claim for a possible reimbursement.

Appears in 1 contract

Samples: policyholder.gov.in

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