| Code | Display |
| claimError-1 |
The claimed service is not covered under the policy, and therefore, the amount is deducted. |
| claimError-2 |
The claimed amount exceeds the maximum coverage limit, leading to a deduction. |
| claimError-3 |
The same claim has been submitted more than once, resulting in a deduction. |
| claimError-4 |
The claim needs to be coordinated with another insurance policy, leading to a deduction. |
| claimError-5 |
The claim lacks essential documentation, leading to a partial deduction until proper documents are provided. |
| claimError-6 |
The claim amount is subject to the policy deductible, leading to a deduction. |
| claimError-7 |
The claimant is responsible for a portion of the service cost due to co-payment or coinsurance. |
| claimError-8 |
There is an error in the claim submission, leading to a deduction until the correct information is provided. |
| claimError-9 |
The claim is determined to be fraudulent, leading to a complete/partial deduction of the amount. |
| claimError-10 |
The claimed service is deemed medically unnecessary, leading to a deduction. |
| claimError-11 |
The claimant has reached the maximum benefit limit, resulting in a deduction. |
| claimError-12 |
The claim was not submitted within the required time frame, leading to a deduction. |
| claimError-13 |
The claimed service has already been paid for, leading to a deduction. |
| claimError-14 |
Claim has been rejected due to less tha 24 hours of hospitalization |
| claimError-15 |
Claim has been rejected as the Package is Reserved to Public Hospital. |
| claimError-16 |
Claim has been closed due to Incomplete submission of documents by hospital after multiple queries. |
| claimError-17 |
Claim has been rejected as there was misrepresentation of bed category booked. |
| claimError-18 |
Claim has been rejected due to Outside Scope of cover (Exclusions as per scheme). |
| claimError-19 |
Claim has been rejected as the claim was found be False/Fraudulent. |
| claimError-20 |
Claim has been rejected due to mismatch of package and disease/diagnosis/treatment. |
| claimError-21 |
Claim has been rejected due to hospital not empanelled for this specialty. |
| claimError-22 |
Claim has been closed due to non submission of the documents. |
| claimError-23 |
Claim rejected as the treatment provided does not support the blocked package, request you to book a fresh relevant package. |
| claimError-24 |
Claim has been closed as the photo of the operative site is not available. |
| claimError-25 |
Claim has been rejected due to apparent manipulation in medical record. |
| claimError-26 |
Claim has been rejected as the hospital expenses have been paid by patient. |
| claimError-27 |
Claim has been closed due missing Pre-Auth patient's photo/post operative photo/After discharge photo. |
| claimError-28 |
Claim has been closed as referral letter mandatory for package selected has not been provided. |
| claimError-29 |
Claim has been rejected as the need for hospitalization was not justified based on the available documents. |
| claimError-30 |
Claim rejected as the treatment provided does not support the blocked package, request you to book a fresh relevant package. |
| covered |
Product or Service requested is covered by the policy. |
| preauthError-1 |
Pre-Auth has been rejected as the diagnosis is outside Scope of cover (Exclusions as per scheme). |
| preauthError-2 |
Pre-auth has been rejected due to delay in raising enhancement requests. |
| preauthError-3 |
Pre-Auth has been rejected as it was found to be False/Fraudulent. |
| preauthError-4 |
Pre-Auth has been closed due to delay in preauth Intimation (as per state guidelines). |
| preauthError-5 |
Pre-Auth has been rejected as the Hospital is not empanelled for this specialty. |
| preauthError-6 |
Pre- Auth has been rejected due to mismatch in dialysis records. |
| preauthError-7 |
Enhancement request rejected as the medical necessity of enhancement request not met. |
| preauthError-8 |
Pre-Auth rejected as the medical necessity of ICU bed category not met. |
| preauthError-9 |
Pre-Auth has been rejected as the package selected is reserved for public hospital. |
| preauthError-10 |
Pre-Auth has been closed due to non submission of mandatory document as per STG. |
| preauthError-11 |
Pre-Auth has been rejected as the Surgery was done before Pre-auth Approval. |
| preauthError-12 |
Pre-auth enhancement rejected due to missing patient photo to depict bed category. |
| Queried |
Product or Service requested is queried for clarification. |
| other |
Others |
