See Pramaan in action
Open India-market sample packets — cashless forms, repudiation letters, schedules — then process with Pramaan and see what it finds.
A planned surgery denied as “pre-existing” — ₹2.4L held back
Claim. Cashless request for laparoscopic cholecystectomy under a 3-year retail health policy. Hospital billed ₹2.4L including OT and three-day stay.
Clinical picture. Ultrasound-confirmed gallstones, elective admission, no prior claim on this diagnosis. Waiting period for this condition already completed per policy schedule.
Denial rationale. Insurer A repudiated under “pre-existing disease / waiting period not served,” citing a vague OPD note from year one — underpaying the full package.
REQUEST FOR CASHLESS HOSPITALISATION FOR HEALTH INSURANCE POLICY
(TO BE FILLED IN BLOCK LETTERS) — SAMPLE · FICTITIOUS
| Particulars | Amount (₹) |
|---|---|
| H. Per day room rent + nursing + diet | 8,500 |
| I. Investigation + diagnostic | 12,400 |
| K. OT charges | 45,000 |
| L. Professional fees (Surgeon + Anaesthetist) | 62,000 |
| M. Medicines + consumables | 28,600 |
| O. Package charges (if applicable) | 2,40,000 |
| P. Sum total expected cost | 2,40,000 |
Fictitious sample cases for demonstration. Patient, hospital, and clinical details are invented. Forms mimic IRDAI cashless / hospital packet layouts; payers are anonymized as Insurer A / B / C. Screens are illustrative — not a live product run.
Want Pramaan on your claims queue?
Catch denial risk before you file, then use appeal support with clause-level grounds when a repudiation still comes.