dear sir
myself have meet brain hamerage while returning from offical company tour on jan 20th 2021 and still going on for multiple sitting under neuro doctor till date.
need to know my rights as till date have spend around 25 lac as hospital bill from my pocket but yet haven't received any thing from company insurance. have send bills to insurance company via my employer too but till date no compensation has being given yet.
company is paying me salary yet and myself totally on bed rest due to neurological surgery going on.
every operation bills and hospital discharge summary is shared by me to my company hr and team leader.
please guide further that what is positive and negative in my case as per Indian law.
even email has being dropped to hr from my spouse for the incident happened while returning from offical tour.
please help in drafting an e-mail/petition letter where I can ask for help from my company for this incident happened while I was on duty for financial support.
Company is only saying verbally that they will support but reality is that I haven't got even 1 rupee help from the company itself and insurance that company is provided.
please 🙏 guide as I am going via a bad phase due to financial crunch that has hit our family.
can be reached at tsinghsaini@gmail.com need to get this done. please help and can be connected at above e-mail address.
regards
According to the scenario you have mentioned, let me brief you about the procedure, to file a complaint against a health insurer.
If your insurance agent or HR department cannot help resolve your problem within 30 days, call the insurance company yourself. If a person denies your claim, you can file a complaint.
Before complaining against the health insurance provider, you have to approach the Grievance Redressal Office of the branch. The complaint has to be given in writing with associated documentation. A written acknowledgement will be given to you along with the date of submission of the complaint. Generally, the insurance provider has to resolve the grievance within 15 days. In case this does not happen, the issue can be escalated to the IRDA. It has laid down a Turnaround Time (TAT) for the various services rendered by insurance providers to the insured.
To lodge a complaint against a health insurance provider with the IRDA, you have to get in touch with the Grievance Redressal Cell of the Consumer Affairs Department of IRDA via email or customer care helpline. Once the complaint is filed, you can use the Integrated Grievance Management System offered by the IRDA to monitor your complaint and its progress. You can also contact the IRDA via letter or fax. If the issue is not resolved, you can escalate the issue to IRDA.
Hope it helps,
Regards,
Srishti
