I have a policy with Aditya Birla Health Insurance which includes cashless facility. My father (Simanta Borah) was admitted to the hospital recently. We applied for a cashless claim during admission. 

The hospital initiated the cashless request with the insurer/TPA. However, the insurance company delayed the approval process. At the time of discharge, the claim was not settled, so we had to pay from our own pocket.

After discharge, I submitted a reimbursement claim on 10th March 2026. I uploaded all available documents — prescriptions, diagnosis reports, and follow-up papers.

After a few days, they asked for additional documents like:

	•	Etiology/Cause

	•	First consultation papers

	•	Duration of illness certificate

But this was my father’s FIRST consultation and FIRST hospitalization for this illness. So it is impossible to provide past records or define duration before diagnosis.

I explained this multiple times to customer care.

Each time, they escalated and asked me to wait 3 days. This cycle continued for nearly one month.

Despite all explanations and documents, my claim was rejected.

Claim Number: 1122685121858

Policy Number: 31-24-0282841-01

Email: ankurbora83@gmail.com

So in the end:

	•	“Cashless facility didn’t work”

	•	“We paid from our own pocket”

	•	“Reimbursement was rejected”

	•	“It feels like I paid premiums for nothing.

Has anyone faced something similar?

	•	“What are my options now?”

	•	“Should I escalate to IRDAI or consumer court?”

I trusted my health insurance during an emergency — and it completely failed me.