IBA - National Insurance - PNB - High Deductibles

[Sajjan Garg]

My wife went for robotic Knee replacement surgery recently and hospital billed in total around 5,85000 but IBA did lot of deductibles and approved claim for 3,70000 mentioning the some reasons like above room rent charges and robotic surgery not covered. Did anyone experience same in past ?

Now, I do have SBI top up policy with 5Lakh deductible but they are also not approving till 5 lakh is not met in base policy.

Thanks

Ankit Garg

[Krishnaiah Bondalapati]

Room rent eligibility is Rs5000/- per day for 2 days.(a/c room sharing).. Additional amount charged for robotic surgery will not be permitted..Before undergoing surgery, we should have an understanding that robotic is not mentioned in bill. Overall limit for one leg is Rs250000/- or GIPSA member hospitals has an understanding with IRDA (Rs21600/-) whichever is low. However. pre and post operation charges towards ambulance charges, medicines and for physiotherapy can be claimed.

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[Veera Reddy]

Yes, most of the banks have not received renewed policy.

The hospitalisations taking place on or after 01-11-2025 are done subject to receipt of policy with clear terms.

We have the same experience with Good Health TPA.

Regards

Veera Reddy P

On Thu, Nov 20, 2025 at 9:34 AM Sajjan Garg <saj...@gmail.com> wrote:

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[Sajjan Garg]

Does any one have detailed policy document for IBA - Medical Insurance ?