Reality of cashless hospitalization-world wide?


REALITY OF CASHLESS HOSPITALIZATION-WORLD WIDE?- An attractive advertisement by Indian Insurance Co's to mobilise policies from overseas travellers.

1) Sr.Citizens going abroad to see their children cannot afford to pay the Huge Hospital bills in foreign currencies .That is why the above head lines attract them. But the Insurance Companies/their TPA's  are not providing/guiding them to name or provide the net work hospital's list maintaining this as their Proprietary.  

2) They reply to insured to admit in any hospitals and take their approval simultaneously. Their policy annexures states insuch case they request the hospitals to entertain CASHLESS HOSPITALIZATION and send bills directly to them. Insurer also mentioned that in the event of a hospital not acceding their request the Insured has to directly settle the bill with the Hospital and later claim from the Insurer on arrival to their Home town on which insurar disallow fully or partly  lot of expenses saying Pre-existing or category celings.

3) Foreign Hospitals are not entertaining Insurer's request until and unless that Co or their TPA  prove their credit worthiness .

4) Thus Sr.Citizens are cheated under this ground .

5)  I am one of of the Victim to this, though I am not suffered in Hospital but with the Insurer.

 

Icici Lombard cheating public on overseas insurance Cashless hospital policies-I was one of the victim. In Canada I had false chest pain. I has a shocking news from hospital there that they are not entertaining cashless policies of Indian Insurance .Then I asked Lombard to name the Hospital/Network list in Canada. They refused saying it is Proprietary inspite of warning from V.C of Consumer redressal forum-Delhi on their deficiency of service. After concluding their policy is a waste for me  I arranged a local policy. I cancelled policy of Lombard and asked for full refund. They offered only partial refund. I filed with Insurance ombudsman Chennai. They dismissed my complaint siding Insurer. I had return to India in Nov-2011. I understand time is there to file a case till Nov 2012.  I had purchased this policy on internet-value Rs 25000-for my self & my Spouse.issuing office- Icici Lombard  Mumbai. My residence is Chennai. I want to know weather:

1) I can file a case in District Consumer forum in Chennai based on my Residence (or)

2) I have to file a case in District Consumer forum in Mumbai based on Icici Lombard issuing office- Mumbai. KLY Advice.

I also wonder How REGULATING AUTHORITY -IRDA IS ALLOWING THE INSURER TO ADVERTISE IN A MASS SCALE AND MOBILISING POLICIES WITH OUT SCRUTINISING ON HOW THE INSURED PUBLIC LOCATE HOSPITALS ON EMEGENCIES IF INSURER ARE NOT PROVIDING NETWORK HOSPITAL LIST ON INSURED SPECIFIC LOCATION. I ALSO COMPLAINED TO IRDA AND THEY JUST FORWORDED MY COMPLAINT TO THE iNSURER WITH OUT ANY IMPACT.

I have all Documents to support this case.

I AM MAINLY FIGHTING IN THIS CASE FOR A PUBLIC CAUSE TO GENERATE RELEF TO SENIOR CITIZENS OF INDIA WHO ARE VISITING THEIR CHILDREN ABROAD.

I DRAW THE KIND ATTENTION OF ALL LAW EXPERTS AND APPEAL TO THEM TO KINDLY LEND THEIR SUPPORT TO THIS PUBLIC CAUSE.

Thanking You.

 

 

 

 



Attached File : 324846384 insurance ombudsman.docx downloaded 128 times
 
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self employed

I hv not read fully your mail so I do not know merits of ur case but I know as a insurance agents that most insureres in India are poorly equipped, hv bad quality mangers, TPA's get registration thru wrong means, IRDA, Ombudsman, consumer courts are eye wash and protects insureres. You hv to run piller and post.Only Annajis Lokpal may give right ppl at helms of affair and then only u can hope to get good honest service from these spolt brats of IRDA a Govt of India agency . 

 
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FIN

--ICICI Prudentail Life Insurance has been fined Rs.118 lakh by IRDA.

http://www.irda.gov.in/ADMINCMS/cms/frmGeneral_List.aspx?DF=WAP&mid=30.1

--You may go thru Regulation of Protection of PolicyHolder's Interest.

--IRDA has finalised the protection for Senior Citizens.

http://www.irda.gov.in/ADMINCMS/cms/frmGeneral_NoYearList.aspx?DF=Creport&mid=12

--Policyholder's handbook is available at

http://www.irda.gov.in/ADMINCMS/cms/frmGeneral_NoYearList.aspx?DF=HBKENG&mid=14.7.1

The complaint to IO should be carefully drafted or it rejects.

The insurer should have supplied the list of network hospitals along with policy.



Attached File : 538498942 regulation of protection of policy holders interest 3221 gi 2002 eng.pdf, 538498942 regulation of protection of policy holders interest 3221 gi 2002 eng.pdf downloaded 104 times
 
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practising Advocate

Three cheers for highlighting the so important an issue .The limitation for filing consumer complaint is two years. You will not face any problem as far as the jurisdiction of The District consumer Dispute redressal  Forum Chennai is concerned .Your case is a very strong consumer case.Best wishes for success.

 
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