Critical Illness Claim Rejected? Fight Back & Win! Ombudsman Rules for Policyholder

• A critical illness claim for bacterial meningitis with encephalitis was initially rejected by the insurer.
• Insurer cited non-coverage, but policyholder found the illness was covered under specific conditions (e.g., lasting brain-related problem for over six weeks).
• After insurer's grievance team upheld rejection, policyholder approached the insurance ombudsman.
• Ombudsman reviewed policy terms and medical evidence, ruling in favor of the policyholder.
• Case highlights the importance of understanding policy, keeping records, and using grievance/ombudsman processes to overturn unfair rejections.

Why It Matters: Don't give up on rejected critical illness claims; understand your policy and use official channels.