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Case Ref: CLM-4002-2026
Claim #4002Pending

Hospitalization Examination

Patient: Priya Sharma • Policy: POL2002 (Health Insurance (Senior Shield))

Claimed Amount
₹45,000
Policy Max Limit: ₹10,00,000
Claim Date
14 Aug 2025
Hospital Facility
Manipal Hospital, HAL Airport Rd, Bengaluru
Admission & Discharge
13 Aug 2025 → 14 Aug 2025
Customer Contact
9811223344

Clinical Findings & Invoice Breakdown

Diagnosis & Procedure Description:

Bilateral cataract micro-incision surgery with premium intraocular lens

Hospital Room Rent:
₹12,000 (Within 1% clause)
OT & Surgeon Fees:
₹38,000 (Verified)
Pharmacy & Consumables:
₹15,000 (Audited)

Adjuster Decision Panel

Execute state transitions modeled in the OOAD Claim State Machine.

Current: Pending