There could be a situations where an insurance company may hold or deny cashless mediclaim hospitalisation. Here are a few reason.
a) If the disease/illness is not being covered by your health insurance policy.
b) If the information provided to TPA/insurance company is insufficient and need they need more information.
c) If there is any doubt in the coverage of treatment.
d) If the request for pre-authorisation is not received by insurance company/TPA within the prescribed time limit.
e) If the hospital in not registered by health insurance company for cashless treatment/hospitalization.
f) If the disease/illness is pre-existing and not covered for that period.