HDFC ERGO DENIAL
On May 13, 2026, I slipped on a wet floor and severely dislocated my collarbone, rushing to the hospital where a surgeon visually diagnosed an acute AC joint dislocation—it was so obvious he didn't even need to order an X-ray that day. He told me to admit on same day but I had some personal work .need time for arranging fund as well.
I was admitted on May 19 and underwent a reconstructive Modified Weaver Dunn surgery that evening, with confirmatory X-rays finally taken on May 19 and 20. However, when it was time to discharge on May 22, my insurance company denied my ₹1.8 Lakh cashless claim entirely on the technicality that I didn't have an X-ray from the exact day of the fall (May 13), completely ignoring my surgeon's formal letter explaining the clinical diagnosis.
Note: I am currently collecting all my original documents from the hospital to file for reimbursement. Is it normal for insurance companies to deny a cashless facility over something like this? Do you have any suggestions or tips to ensure my reimbursement claim actually gets approved? What are my rights as a policyholder in this situation, and are there specific regulatory bodies (like the Insurance Ombudsman) I should be preparing to escalate this to if they push back?