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Health Insurance Claim Rejection and Appeal
Claims Officer (speaking English) and Client (speaking Marathi) talk through “Health Insurance Claim Rejection and Appeal”. You interpret both ways — English into Marathi, and Marathi into English — one segment at a time, exactly as in the CCL test.
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Full transcript
Thanks for calling Bupa today, Mr. Deshmukh. I see your claim for the hip surgery at Cabrini Hospital was partially rejected. Let me explain why this happened.
नमस्कार, मला हे समजत नाहीये की माझा दावा अर्धवट का नाकारला गेला. माझी हिप सर्जरी कॅब्रिनी हॉस्पिटलमध्ये झाली होती, मग अडचण नेमकी काय आहे?
The surgery falls under a twelve-month waiting period for pre-existing conditions, which hadn't been served yet when you had the operation.
ठीक आहे, पण हा बारा महिन्यांचा प्रतीक्षा कालावधी नेमका कधीपासून सुरू होतो? माझी पॉलिसी सुरू होऊन किती महिने झाले हे मला नक्की आठवत नाही.
Yes, it's twelve months from your policy start date. Since you joined only eight months ago, the surgery wasn't covered under your current policy.
म्हणजे मी काहीच करू शकत नाही का? माझी सर्जरी खरंच गरजेची होती, ती पूर्व-अस्तित्वातील समस्या नव्हती.
You can lodge an appeal with Bupa if your doctor confirms the condition wasn't pre-existing. The appeal form is available on the Bupa website.
ठीक आहे, मी अपील करेन. पण या अपीलाचा निकाल यायला साधारण किती वेळ लागेल?
The appeal review usually takes about three weeks, unless you request an urgent assessment due to financial hardship.
आणि तोपर्यंत मला हॉस्पिटलचं बिल भरावं लागेल का? किती रक्कम भरावी लागेल याबद्दल काही कल्पना आहे का?
You'll still need to pay the gap payment of eight hundred and fifty dollars now. If the appeal succeeds, that amount will be refunded.
ठीक आहे, मी आठशे पन्नास डॉलर्स आत्ता भरतो आणि अपीलाच्या निकालाची वाट पाहतो. मदतीबद्दल धन्यवाद.
Terms in this dialogue that cost marks
CCL is marked on information transferred. These Australian terms have no direct word in most test languages — get one wrong and the segment's information is gone.
- waiting period'प्रतीक्षा कालावधी' असे सरळ भाषांतर वापरावे, उदा. 'या भत्त्यासाठी प्रतीक्षा कालावधी आहे'.
- financial hardship'आर्थिक अडचण' किंवा 'आर्थिक संकट' असे सहज मराठी वाक्प्रचार वापरावा.
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Same topic · Insurance
How the test works
Practice dialogue written to the CCL specification (two speakers, segments of 35 words or fewer, about 300 words). It is a practice text, not a NAATI test paper, and the AI score is this site's estimate, not a NAATI result. All Marathi dialogues · All languages