My son is having health insurance policy for his family from UIICo since April 25,2011 and was also covered under policy taken by his office. In December 2011 my daughter in law was operated for rectal ulcer. Total expenditure was approximately Rs. 6.00 lack. Out of this amount Rs. 2.00 were passed by office insurance company and for Rs. 3.00 lack we sent the claim to TPA allotted by UIICO but they rejected the claim. Then we filed application in District Consumers Forum but they never appeared in the court. The court passed ex-party orders in our favour directing the insurance company to pay the amount along with interest. Then the insurance company appealed in State Commission. There also the insurance company did not appear in the court on three consecutive dates. The State Commission dismissed the application ex-party. Then we filed execution in district court for payment. In April, 2013 the insurance company paid the amount along with interest. Now after six and half year the insurance company has filed C. M. In appeal of 2012.Is it legal after a long period while earlier insurance company was given opportunity to defend but they didn't appear. If they had objection they could appeal in National Commission instead of giving payment to us against full settlement. Please advise. From:- Rajender Goel
Dear client, withour directly resorting to the complaint on the insurance company try to re-inititate the claim process and talk to them and submit the required documents. Even then if there is no cla...
Dear Client,
In the given situation, bring the matter to the notice of the Grievance Cell of the concerned Insurance Company endorsing a copy to the insurance regulatory authority, IRDIA. In case, no...
Dear Client,
Pre-existing diseases (PED) are mostly expensive to treat as they are chronic in nature. Unfortunately, most health insurance plans cover pre-existing diseases after a waiting period of 2...
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