So my grandfather recently had a knee replacement surgery, for which we received a claim of 3.75 lakhs from star health insurance out of the 5 lakh policy , now due to the heavy medications, his stomach has been filled with fluid post operation due to the affect of the medications on his kidneys. Now due to this he has been admitted into icu for the removal of the fluid. Due to this we filed for claim with the 2 health insurance providers Star health insurance and national health insurance (each policy is of 5 lakhs) but both of them have rejected the claim saying that kidney problem do not occur suddenly and it has to be a long term issue which we did not disclose to them. Prior to the knee replacement surgery, his medical tests were conducted on the 23rd April, in which everything was fine and all his reports were normal due to which the surgery was conducted.
We have medical reports of those test proving that it was not a long term issue but the claim is still being rejected, So I want you guys advice on whether it is possible to get the claim or not and what should we do further.