Ray Insurance Pre-Existing Condition Claim Denial

10

On 15.08.2026, I went to the Gastroenterology department of Medical Park Pendik Hospital with a complaint of pancreatic pain. Based on my complaint, the doctor requested a pancreatic MRI, a stool elastase test, a colonoscopy and an endoscopy. However, my complementary health insurance policy with Ray Insurance once again rejected these procedures on the grounds of a “pre-existing condition”. Today I received a call from 0212 306 00 00 and was told that the procedures were rejected because the doctor entered “abdominal pain and diarrhea” into the system. In reality, no one would go to such a highly specialized department for a simple abdominal pain; gastroenterology is already a unit that requires serious and detailed examination, and the doctor clearly requested tests related to the pancreas. Despite this, I do not accept that Ray Insurance insists on rejecting these procedures. This is my second year with this policy and for almost two years I have received similar rejections for almost every examination. When I spoke with customer service, they said that I was actually right but that they “could not do anything”, which has further increased both my grievance and my mistrust. In the last rejected case, the uncovered amount was around ₺16,713 and I do not accept being forced to pay this amount out of my own pocket. I request that all tests and the detailed examination report related to this last visit be re-evaluated based on my real complaint of pancreatic pain, that the entire amount of ₺16,713 be covered under my policy, and that all similarly rejected procedures in the past two years be reviewed once again.

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