Insurance related query
Rammohan
(Querist) 08 July 2013
This query is : Resolved
My wife delivered baby girl on March 29.
Hospital used my cashless insurance policy
and informed me that insurance company agreed to pay 29K and i should pay
remaining 17K. I paid 17K by april 02
during discharge. After 3 months, my
hospital claims that insurance company
refused to pay 5K and now asking me to pay
it. I said its up to you and insurance
comapany and refused to pay. They are
threatening me now with legal action. Pl
suggest who is at fault and liable to pay the 5K
ajay sethi
(Expert) 08 July 2013
if insurance company has refused to pay you have to settle the hospital bill . you can drag the insurance company to consumer forum if they have wrongly rejected the claim .find out reasons for refusal by insurance company .
Rajendra K Goyal
(Expert) 08 July 2013
Take all the details of the items for which insurance company refused payment. Find out whether the same are payable as per the terms of insurance. In case some claim irregularly not paid send a notice to insurance company for payment. If not paid move either to Consumer forum or to the parmanant lok adalat(public utility service)
R.K Nanda
(Expert) 08 July 2013
agree with experts.
Raj Kumar Makkad
(Expert) 10 July 2013
You shall have to pay too the hospital first under protest and thereafter shall have to raise the complaint before the insurance company and then before the consumer fora.
