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suryagaurav (manager)     15 November 2008

non payment of mediclaim by insurer co.

national insurance co.,delhi has provided a TPA park mediclaim and when I submitted all papers in original to them ,after one month they are demanding one of the paper in original which I already submitted  to them in original ,it seems that they are using their tactics to not to make my claim payable by them, I am in a dilemma what to do as I had submitted each and every paper to them, at present I am having only photocopy of my papers/records,plz suggest ,it is a mediclaim policy.I have placed my claim in april 08,till date no hearing from their side except demand of that doc.which is prescription by doctor to admit the patient(my wife) in Hospital.


Learning

 17 Replies

K.C.Suresh (Advocate)     15 November 2008

Dear Fiend, The last part ion your querry is not followed. I repeat the same "at present I am having only photocopy of my papers/records,plz suggest ,it is a mediclaim policy.I have placed my claim in april 08,till date no hearing from their side except demand of that doc.which is prescription by doctor to admit the patient(my wife) in Hospital". Make it clear friend.


You can apply for the certified copies of the documents with aid of the photocopy. If they try to cheat you you can take criminal action against them.

SHEKHAR MISHRA (public servant)     15 November 2008

file   a   complaint   case   against   the   co. for  cheating.

H. S. Thukral (Lawyer)     15 November 2008

Non settlement of claim in time amounts to deficiency in services. You file a complaint in consumer court for redressal of your grievance. 

Srinivas.B.S.S.T ( Advocate)     15 November 2008

 Rightly opined by Harbhajan Ji, file a consumer complaint. Have they given any reson for repudiation of your claim 

SANJAY DIXIT (Advocate)     15 November 2008

More than sufficient time has been passed, you should take action against them immediately. As suggested by the learned members above, You may file a complaint in consumar forum as well as initiate for criminal action.

S.B.adil rahman (Legal Consultant )     15 November 2008

Disputes in Mediclaim settlements are the order of the days. I had faced the same problems with Oriental Insurance.But i got a decree from consumer court and received the claimed amount in full with interest. Can any one explain as to what should be the time limit to wait for the reimbursement of the claim.How long a consumer should wait for decision of the Insurance Copmpany?

suryagaurav (manager)     17 November 2008

thanx all of you learned friends to help me

nirav (Private)     02 December 2008

When you had submitted all documents in Original did you attach a FOrwarding letter listing all the enlosed original doucments and did you get in inwarded in the office personally or did you sent in by UPC or Registered post. WHile submitting oringinal documents one should always get an acknowledgemnt from the comany.


Please contact me. I am into Insurance since15 years and now entering into Insurance Law. mail: nirav@voiceindia.co.in

ca.bhupendrashah (FCADISA)     02 December 2008

use RTI

ca.bhupendrashah (FCADISA)     02 December 2008

WRITE TO OMBUDSMAN

kumar (testing)     03 December 2008

thanks

Uma parameswaran (lawyer)     10 February 2009

Collect the orginal documents without delay and move before consumer Court.

suryagaurav (manager)     10 February 2009

thanx bro, about 10 days  ago an investigator came to me and enquired the matter , now what shud i do plz guide

Pankaj Rai (Lawyer)     23 February 2009

you may file a comlaint against insurance company before ombudsman.


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