MediclaimSaathi
₹1.9L
example claim
90s
to your answer
From rejection to resolution, in 90 seconds.
IRDAI claim recovery
From rejection to resolution.
Upload a photo of your rejection letter to start your resolution.
- Why it was rejected — in plain words, in 90 seconds
- Your case strength checked against IRDAI 2024 rules
- Every legal deadline, counted down for you
Free ₹0Basic ₹49Pro ₹99Zero commission
Common unfair rejection clauses we challenge every day:
Pre-existing Disease (PED) 36-Month Clause
ICU Clinical & Parenteral Nutrition Disallowance
Room Rent Proportionate Deduction
Delayed Claim Intimation (>24h)
Not Medically Necessary Allegation
Cosmetic vs Functional Surgery Dispute
Investigation / Diagnostic Admission
Cataract & Joint Replacement Sub-limits
Pre-existing Disease (PED) 36-Month Clause
ICU Clinical & Parenteral Nutrition Disallowance
Room Rent Proportionate Deduction
Delayed Claim Intimation (>24h)
Not Medically Necessary Allegation
Cosmetic vs Functional Surgery Dispute
Investigation / Diagnostic Admission
Cataract & Joint Replacement Sub-limits
Patient Medical Education & Cardiac Rehab Cuts
Non-disclosure of Past Incidental OPD Visits
Consumables & PPE Over-deductions
Robotic / Advanced Treatment Cap Exceeded
Daycare Procedure Rejection
Temporary Policy Portability Break
ICU Charges Disallowance
Congenital Anomaly Repudiation
Patient Medical Education & Cardiac Rehab Cuts
Non-disclosure of Past Incidental OPD Visits
Consumables & PPE Over-deductions
Robotic / Advanced Treatment Cap Exceeded
Daycare Procedure Rejection
Temporary Policy Portability Break
ICU Charges Disallowance
Congenital Anomaly Repudiation
Simple 3-Step Process
How MediclaimSaathi works
Three clear steps to turn an unfair rejection into an approved claim.
01
Upload your letter
Take a photo on your phone. 1 free check per account. Sign in with Google, no password.
Phone photo or PDFSign in with Google
02
Instant Statutory Analysis
We analyze the cited policy clause against IRDAI 2024 regulations, moratorium rules, and Ombudsman precedents.
IRDAI 2024 RulesUnder 90 sec
03
Send ironclad appeal
Generate customized statutory grievance letters for the Insurer, Bima Bharosa, and Ombudsman. Track every deadline.
GRO + OmbudsmanDone for you
TRANSPARENT FIXED PRICING · NO PERCENTAGE CUT
Fair Pricing. Zero Commission.
Why pay a share of your claim to a recovery agent? Choose an instant check or a complete ready-to-file legal grievance pack.
100% FREE
Run Free Check NowFree Claim Check
₹0/ 1 check
Every account gets 1 free check: the rejection reason in plain words, case strength and your next deadline.
- Case strength score (Strong / Weak)
- Statutory deadline verification
- Plain Hindi, Hinglish or English
MOST ACCESSIBLE
Start Basic Appeal (₹49)Basic Grievance Pack
₹49/ one-time
Adds 2 checks. Each comes with counter-arguments, a missing-documents checklist and a ready grievance letter.
- Everything in Free Check
- Formal Insurer GRO Grievance Letter
- Customized missing documents checklist
- Automated 30-day response reminders
RECOMMENDED
FULL TIER 1 TO 3 DOSSIER
Get Full Pro Pack (₹99)Pro Ombudsman Pack
₹99/ one-time
Adds 4 checks. Each gets everything in Basic plus Bima Bharosa text, an Ombudsman draft, charts and the PDF dossier.
- Everything in Basic Pack
- Insurance Ombudsman Filing Kit
- Bima Bharosa Portal copy-paste inputs
- Clinical Nutrition (Item 19) modules
EXAMPLE CASES
How a rejection can be challenged
Illustrative examples, not real customer cases. Names and amounts are made up to show how the rules work.
PED RepudiationExample · ₹2,40,000
Priya (34, Delhi NCR) · Knee Surgery Claim
Her father's claim was rejected citing non-disclosure of pre-existing joint condition. MediclaimSaathi verified 52 months of continuous policy renewal, which triggers the IRDAI 36-month moratorium rule barring the repudiation.
Open the sample dossierIllustrative example
Clinical NutritionExample · ₹42,000
Sunita (45, Mumbai) · ICU Enteral Feeds
TPA deducted ₹42,000 labeling ICU specialized parenteral amino acid infusions as "food & diet expenses". Reversal prepared citing IRDAI Item 19 classifying prescribed clinical nutrition as essential medicine.
Learn Nutrition RightsIllustrative example
IRDAI MASTER CIRCULAR 2024
Know Your Rights Before You Accept a Denial
Did you know? Under IRDAI Item 19, specialized clinical nutrition is legally medicine. Under Clause 6.1, policies older than 36 months cannot be denied for PED. Insurers cannot deduct MRP medicines proportionally.
36-Month MoratoriumItem 19 Clinical Nutrition30-Day Insurer SLA
Clear Answers
Common Questions About Claims
Everything you need to know about your statutory rights under IRDAI regulations.
Under the IRDAI Master Circular 2024, the statutory moratorium period is now strictly 36 months. Once your health policy has completed 3 continuous years (including ported tenure), the insurer is legally prohibited from repudiating claims on grounds of non-disclosure or pre-existing diseases, except in cases of proven court fraud.
STRICT 30-DAY STATUTORY APPEAL WINDOW
Don'tlettheinsurerkeepyourmoney.
Every day you wait brings you closer to the 30-day appeal deadline. Check your letter right now in 90 seconds. We challenge unfair repudiations across Pre-Existing Diseases, ICU room rent caps, Clinical Nutrition disallowances, and Patient Education & Rehabilitation cuts.
Zero Sign-up to Check
Results in 90 Seconds
Nutrition & Education Covered
Free ₹0 / Basic ₹49 / Pro ₹99