MDIndia Health Insurance TPA Operations Executive Interview Questions and Answers

The claim may not be approved as the customer's death could be attributed to the drink.

• The customer's death may be considered as a result of their own actions, drinking excessively.

• If the customer's death is directly linked to the drink, the claim may not be approved.

• The insurance company may investigate the circumstances surrounding the customer's death before approving the claim.

The approved amount for the hospital is Rs. 88,000, with Rs. 12,000 deducted for an unknown reason.

• Total amount of the hospital: Rs. 1,00,000

• Approved amount: Rs. 88,000

• Deducted amount: Rs. 12,000

• Reason for deduction is unknown

The second way to process a cashless claim that is not approved is to submit a reimbursement claim.

• The insured can submit all the necessary documents and bills related to the claim for reimbursement.

• The reimbursement claim will be processed based on the policy terms and conditions.

• The insured will receive the reimbursement amount after deducting any applicable deductibles or co-pays.

• Examples of documents required for r...read more