Allianz Denied Surgery Pre-Authorization

67

On November 7, 2025, we submitted a pre-authorization request at WM Medical Park Pendik Hospital for my mother under Allianz Private Health Insurance and Supplementary Health Insurance coverage. The SGK registration was completed at 11:05, and the request was received by Allianz at 11:08. However, only 10 minutes later (at 11:19), our request was denied with the response “not covered under the policy.” It is not possible for the application to be medically reviewed, reports examined, and compared with policy terms in such a short time. Therefore, I believe the decision was made automatically by a system, without any manual evaluation. Moreover, the related medical reports do not indicate any surgical decision—only follow-up was recommended. Despite this, the rejection was issued without consulting a doctor. This situation unnecessarily restricts insurance coverage and causes us, as customers, to suffer. We have been continuously insured since 2021. For a surgery planned in 2025, reports from 2020 were requested. It is medically impossible for a fast-growing cyst to remain unchanged for five years. Additionally, similar requests for examinations had been rejected in the past. Our authorization number is 100869787. I have already contacted Allianz customer service but have not received any response. We have not yet made any payments; however, if a prompt solution is not provided, we will have to cover the surgery costs ourselves. My request is for our pre-authorization application to be re-evaluated, with a doctor’s opinion obtained, a written and detailed justification provided to us, and the patient’s urgent surgery expenses covered under the insurance policy.

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