Cataract - Congenital ? Internal or external?

[GAURHEME]

Hi,

My 3-month baby was diagnosed with cataract.
She had undergone operation in both the eyes.
My corporate health insurance policy covers treatment for all congenital internal diseases of my family.
However, my insurers have rejected my claim by classifying her case as "congenital external disease".
There is conclusive evidence if the cataract was congenital or not in the first place.
In fact at the time of birth, the paedatrician informed us that she was healthy. Am not sure if he missed to diagnose the cataract then or cataract developed later on due to some reason.
Can someone please advice whether cataract is considered as an internal or external disease?

Regards,
Gaurav

[John C Hagan III, MD, FACS, FAAO]

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[GAURHEME]

Thanks John!

[John C Hagan III, MD, FACS, FAAO]

Cataracts are always internal eye disease. I have never heard of any insurance policy that excludes "external eye disease". Your corporation should have a human resources person that should be able to work through this claim, if it doesn't then get yourself a health lawyer to advocate for you. Your child should be covered.

JCH MD