Originally Posted by
Cygnus_A
I have a health insurance with New India Assurance Co Ltd covering both of us, husband and wife.
Both are senior citizens.
Recently my wife had a very unfortunate and nasty accidental fall from a step of a temple causing serious fracture to her right femur shaft. She had a very serious and complicated surgery, intramedullary interlocking nailing , by an orthopedic surgeon.
After discharge from hospital, she is now recuperating at home.
Now the problem arises to fill up the claim form for reimbursement of the expenses incurred during hospitalization.
For cause of hospitalization, three options, (i) injury, (ii) illness and (iii) maternity, are mentioned.
Common sense suggests 'injury' in this case.
If that option is taken, then as cause of injury three option are mentioned.
, viz, (i) self inflicted, (ii) road traffic accident and (iii) substance abuse/alcohol consumption , none of which appears relevant here.
Or, in health insurance definition 'self inflicted injury' includes accidental fall induced injury as well ?
And in that case, will the claim be admitted ?
Please, clarify.
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