Mediclaim floter policy
Rajesh Agarwal
(Querist) 26 April 2014
This query is : Resolved
Dear Sir,
I am having a swastha Bima Policy with National Insurance Co. Ltd.,from the year 2006. It is a Floter policy were a person upto the age of 75years is covered for Medical benefits, in which my father aged 68years, mother - 63years, my self -41years, and my wife -35years are health risk is covered. Now the policy is due for renewal in the month of May'2014, when I applied for renewal the Manager of the NIC says that the policy was wrongly issued at that time because this is a Policy were husband wife and his two childrens are covered. Now sir it is not possible for me to take a fresh Mediclaim Policy for my Parents as there are no such Policies in which at this age a entry is possible. I have read some days before in a news paper a verdict from the apex court has been given to the Insurance Companies that they cannot deny to renew health Insurance Policies at any Grounds? Is it show than please Share and advice me..
Thanks and Regards.
Rajendra K Goyal
(Expert) 27 April 2014
Send legal notice followed by complaint with consumer forum.
Kumar Doab
(Expert) 27 April 2014
Post the link to the news in paper you have mentioned about verdict from apex court.
Each paper has e-paper also and you can easily find out.
Has the manager replied in writing?
If he is denying to decline in writing record(audio/visual) and keep witness.
Do you have acknowledgment of renewal?
There shall be a resolution to your query.
Insurance is also portable now!
Kumar Doab
(Expert) 27 April 2014
You are right.
You may go thru:
INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY
(HEALTH INSURANCE) REGULATIONS, 2012
and notification on:
INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY
(HEALTH INSURANCE) REGULATIONS, 2013
Insurance Regulatory and Development Authority (Protection of Policyholders’ Interests) Regulations, 2002................and amndments
Insurance Ombudsman decisions;case laws
http://www.policyholder.gov.in/Case_laws_or_Judgements.aspx
You may consider opting for Individual Sr.Citizen policy for your parents.
As per various publications now there is no exit age for health insurance policies.
Senior Citizens
The premiums for health insurance policies for senior citizens will be reasonable. Any loading should be informed in advance. Different channel will be set up by health insurers and TPA to address claims and grievance of senior citizens.
Multiple Policies:
The contribution clause has been removed. If a person had multiple health covers, the claim amount was shared proportionally by insurers as per the Sum Assured. However now as per new regulations, policyholder can choose the insurer from whom he wants claim to be settled. The insurer cannot insist on contribution anymore.
http://knowledge.policybazaar.com/health-insurance/item/1045-health-insurance-regulations-2012.html
http://vyasa-kaaranam-ketkadey.blogspot.in/2012/06/irda-landmark-draft-health-insurance.html
http://www.medindia.net/patients/insurance/health-insurance-for-senior-citizens-irda-guidelines.htm
Advocate Bhartesh goyal
(Expert) 27 April 2014
Insurance company can not deny to renew the mediclaim or health policy on any ground it is not only their unfair trade practice but also shows their deficient services to customers.Serve a legal notice to Insurance Company in this regard and if notice not complied with than file complaint before District consumer Redressal Forum.
T. Kalaiselvan, Advocate
(Expert) 30 April 2014
The renewal of policy cannot be out rightly declined by the Insurance company, if the company declinesthe same and the decision has been communicated in writing, you may approach either IRDA of Insurance Ombudsman seeking relief.
Rajesh Agarwal
(Querist) 28 September 2014
Dear Sir,
The Insurer has denied in writing the renewal of the Policy inspite of the intervention of the IRDA. Sir, I want to know that it would be feasible that:-
1. Will I apply with the High Court to get order for renewal of the Policy that is maintaining the status co of the Policy immediately so that the coverage of the Policy is provided in the meantime. Is it possible and if Possible than please suggest a Advocate at Kolkata High Court for the Same.
2. Or Will it be better to apply with the Consumer Forum , there the order would be delayed and in the mean time they would not allow to renew the policy which would be possible only after Consumer Forums Order.
Please suggest.
Thanking you',
with Regards,
Rajesh Agarwal
ajay sethi
(Expert) 28 September 2014
Mr barman is a senior expert and practises in kolkata . you can contact him in this regard
