Issue with insurance company

1 year ago

I have issue with insurance company,
While I am working on private limited company, i have put medical insurance for father also in group medical cover , but i extied from the company after two months my father got sick , but health id card shows it still active for 6 months , so I have admitted my father get operation done and insurance tpa give pre authorisation and as well post hospital cashless apporaval and even they send around 34k reimbursement of post and pre hospital expenses but after 1 year suddenly I got call from hospital they did receive money from insurance ask pay 1.1l bill amount and i filed complaint on insurance obusedmen they also said I am not on job while tretment taken ,so what can I do whether like USA any surprise bill act is there in India ?

Can we get any settlement if file complaint on consumer court or i need to pay that

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Anik

Responded 1 year ago

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A.Dear Client

In India, there is no similar law to the surprise bill act in the USA, but if the insurance company has approved pre-authorization for treatment and post-hospital cashless approval, they are liable to pay the bills. You can approach the insurance ombudsman or consumer court and provide all relevant documents to support your claim.Please seek an expert legal advice over this matter.

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