UnitedHealthcare Parekh TPA Pvt.

Ltd
3B Gundecha Onclave,
Kherani Road,Sakinaka,Andheri(E.),
Without Prejudice
Mumbai 400072
Tel.+ 91 22 30657300
Date : 18/04/2011
Fax + 91 22 28528222
Url No. : 447514-1 www.uhcpindia.com

To,
NALIN MOHAN
Oracle Financial Services Software Limited

Name Of Claiment ATUL AGARWAL

Membership No. 33132

Policy Period From 25/04/2010

Policy Period To 24/04/2011

Policy No. 500100/48/10/41/00000028

Hospital Name Kokilaben Dhirubhai Ambani Hospital

Date Of Admission 14/02/2011

Date Of Discharge 02/03/2011

Insurance Company United India Insurance Co. Ltd(CORPORATE CELL)

Claimed Amount Rs. 315619 /-

Claim Type Non-Credit

Diagnosis Acute cholecystitis

Dear Sir /Madam,

We regret to inform you that the above claim lodged by you is rejected due to the following :

Reasons : Present claim is in respect of Mr Agarwal Atul 54 yrs old male patient hospitalized from 14.02.11 to 02.03.11
with complaints of -Epigastric pain , vomitting ,diagnosed to have Acute Cholecystitis with Pancreatitis ,
underwent Lap Cholecystectomy .As evident from the submitted claim documents,it is observed that this ailment is
a direct effect of abuse of intoxicating substance ( Alcohol) . Hence we are unable to consider this claim for
admissibility under exclusion clause no. 4.8 of your policy , which states the following.

Clause No.: 4.8 Insurance Company:United India Insurance Co. Ltd

Clause Description: Convalescence, general debility; run-down condition or rest cure, Congenital external disease or defects or
anomalies, Sterility, Venereal disease, intentional self injury and use of intoxication drugs / alcohol.

Please feel free to get in touch with us for any further clarifications.

With Regards,

for UnitedHealthcare Parekh TPA Pvt.Ltd.

Claims Department