Health Insurance company asking for the MLC certificate but hospital denying MLC
10 months ago
Health Insurance company asking for MLC as it is a road accident, So I requested Hospital for it but hospital that is not the case of MLC
My father had a road accident due to driver turned the car in the speed of 50 in order to save the biker who is coming from the wrong side and due to which car turned upside down.
Please answer what to do, really helpless
A.Dear Client,
Medico-Legal Certificate (MLC) is required in cases of a road accident or an incident that has led to injury or death. Sometimes patients are admitted straight to an emergency room for medical attention. In such cases. In government hospitals and most of the major private hospitals, a medico-legal register is maintained wherein accident cases are registered by hospital authorities at the time of admission/treatment and submitted to the local police station. Based on the report, the police visits the patient to verify the details mentioned in MLC. So, on the basis of the report recorded in the MLC register of the Hospital which was reported to the local PS, you may pursue the matter from the local PS. In case of refusal from both the Hospital and PS to provide you the MLC which is essentially required for settlement of insurance claim, you may make a complaint to the CMOH of the District or an application under RTI Act, 2005 to the concerned Public Authority(SPIO) seeking the documents from the concerned authority.
Medico-Legal Certificate (MLC) is required in cases of a road accident or an incident that has led to injury or death. Sometimes patients are admitted straight to an emergency room for medical attention. In such cases. In government hospitals and most of the major private hospitals, a medico-legal register is maintained wherein accident cases are registered by hospital authorities at the time of admission/treatment and submitted to the local police station. Based on the report, the police visits the patient to verify the details mentioned in MLC. So, on the basis of the report recorded in the MLC register of the Hospital which was reported to the local PS, you may pursue the matter from the local PS. In case of refusal from both the Hospital and PS to provide you the MLC which is essentially required for settlement of insurance claim, you may make a complaint to the CMOH of the District or an application under RTI Act, 2005 to the concerned Public Authority(SPIO) seeking the documents from the concerned authority.
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A.Dear client,
In medico-legal cases, the opinion of the doctor in deciding whether the particular case comes within its ambit or not is final. A medical case becomes a medico-legal case when the attending doctor clinically examines the patient and their history and forms the opinion that an investigation by law enforcement is needed. Hence, a doctor should consider whether a case is a medico-legal case or not on the basis of the fact
If the hospital is refusing to treat it as a medical legal case, then a medical legal certificate cannot be issued
In medico-legal cases, the opinion of the doctor in deciding whether the particular case comes within its ambit or not is final. A medical case becomes a medico-legal case when the attending doctor clinically examines the patient and their history and forms the opinion that an investigation by law enforcement is needed. Hence, a doctor should consider whether a case is a medico-legal case or not on the basis of the fact
If the hospital is refusing to treat it as a medical legal case, then a medical legal certificate cannot be issued
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Harshit Verma
Replied 9 months ago
Thanks a lot Sir for the detailed answer, I got lots of help from your answer
A.Dear Sir,
You have to obtain FIR from the Police Station and consequently also get medical certificate from the local hospital where your father was treated after accident. Those two documents are sufficient for the insurance company to release insurance claim.
You have to obtain FIR from the Police Station and consequently also get medical certificate from the local hospital where your father was treated after accident. Those two documents are sufficient for the insurance company to release insurance claim.
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Harshit Verma
Replied 9 months ago
Thank you sir for your response.
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