Formal Complaint Regarding The Rejection Of Endoscopy Coverage

I am writing to express my disappointment and concern regarding the handling of my recent medical procedure under my supplementary health insurance with Ray Insurance Vienna (Supplementary Health Insurance). On August 14, 2026, I underwent both a colonoscopy and an endoscopy at Memorial Bahçelievler Hospital in Istanbul due to abdominal pain and a serious medical concern about a possible polyp or tumor. These procedures were requested by my doctor as part of the current diagnostic process for a new and potentially serious health condition, not as a follow-up for any old or chronic diagnosis. After the procedures, I was informed that the endoscopy would not be covered under my policy. The justification given was that I had been diagnosed with reflux approximately 14 years ago, following an endoscopy performed at that time. I find it unacceptable that a medical procedure requested now, in 2026, for a new and serious suspicion such as a polyp or tumor, is being excluded from coverage based on a reflux diagnosis from 14 years ago. What makes this situation even more disappointing is that I was not proactively informed about this exclusion in advance. I only learned that the endoscopy would not be covered after I personally contacted the insurance company on 27.08.2026 to ask about the status. As a result, I had to pay ₺25,000 out of pocket for the endoscopy at Memorial Bahçelievler Hospital. I request a full reimbursement of the ₺25,000 I paid for the endoscopy and a review and reversal of the non-coverage decision, considering that this procedure was clearly part of the diagnostic work-up for a new and potentially serious condition. I also expect a clear written explanation of how such decisions are made, and why an old reflux diagnosis is being used to deny coverage for a current, medically necessary procedure related to suspected polyps or tumors. I expect you to urgently review my case, overturn this decision, and refund the ₺25,000 I have paid.