Raject my claim
Raject my claim
Dear sir My driver lost his balance and got driven car into the water due to rain, there may be less possibility of external impacts/damages. And the insurance company deny my claim due to any extern
1 week ago
A. Dear client
Carefully read through your insurance policy to understand the terms and conditions, especially those related to coverage in case of accidents, damage, or loss. Communicate with the insurance company to seek clarification on the denial of the claim. Ask them to provide specific details on why they believe the incident is not covered. Gather evidence and document the incident thoroughly. This may include photos of the accident scene, any relevant weather conditions, and statements fro ...ReadMore
Regarding refund of ported policies
I paid for insurance policies with Star Health Insurance by mistake, which have been ported to another insurance company as per portability guidelines. Payment was made on 11th oct and request for ref
4 weeks ago
A. Dear Sir,
You may approach insurance ombudsman if fail to get any positive result then approach Consumer Court.
Reimbursment from blacklisted hospital
I have a corporate MediAssist policy and got my mother operated for spine surgery at one of the blacklisted hospitals which I have to came to know after 10 days of discharge. The insurance team is c
1 month ago
A. Dear Client,
In the given situation, Apart from the settlement of the insurance claim, there is an alternative way to resolve your grievance. All the hospitals, nursing homes and other clinical establishments are issued licenses by the Licensing Authority and the Chief Medical Officer of Health of the District under the Clinical Establishment Act of the respective State. In the said governing Act, there is a chapter for contravention of the provisions of the Act and a penalty to be imposed for ...ReadMore
Reimbursement claim in health insurance
My father got slipped and his waist got fractured. When we admitted him to hospital then doctor suggested for surgery. We went through surgery and treatment. Now when I sent expense documents to insur
1 month ago
A. Dear Client,
Every Hospital/Nursing home keeps an MLC register wherein accident/ assault/poisoning/ burn cases are registered by hospital authorities and submitted to the local police station. Fall and fracture of body parts is considered an accident and comes under the purview of Medico-Legal Cases. A medico-legal case should be registered by the treating Doctor of the hospital as soon as the patient is brought to the Hospital and admitted for necessary treatment. Under Section 39 of Cr.PC, the ...ReadMore
Third party insurance
So.. I went and hit a car which was second hand and the registration certificate of the same is not been transferred to the car owner. My third party insurance claim is being rejected from the other e
1 month ago
A. Dear Client,
It is mandatory to have a third-party insurance policy as per the Motor Vehicles Act, of 1988 which is a basic requirement to legally ply a vehicle on Indian roads. A major disadvantage to having third-party motor insurance is that you are not covered for any damage to your vehicle in an accident. This means that you will have to pay for any repairs to your vehicle out of your own pocket. A 3rd party insurance policy provides compensation for bodily injuries or demise of a third pa ...ReadMore
Legal issue against holding three health insurance policy
I already have one heath insurance policy running from myself from ICICI Pru Life and another from LIC in family floater mode. As the aggregated sum assured is still quite low (6 Lakh only). May I tak
1 month ago
A. Dear Client,
A policyholder can have multiple health insurance policies. However, he cannot claim reimbursement for the same expense from multiple insurers. If one cover is not sufficient, the other cover can be used to cover the expenses. Having two/three health plans can help cover normally out-of-pocket medical expenses, but also means you'll likely have to pay two premiums and face two deductibles. Your primary plan initially picks up coverage costs, followed by the secondary plan.
LIC agents gave wrong information verbally
Hi team, I have a LIC policy, Jeevan Aadhar (114) with me as life insured and my mentally retarded sister as nominee. The agents(2 agents) told this is a special plan for differently abled children. T
2 months ago
A. Dear Client,
In the prevailing situation you may take the following stemps to redress your grievance - 1) File a Grievance before the GRO of the Divisional Office of the LIC conderned, 2) File a complaint under IRDA(Protection of Policyholders Interest) Regulations, 2002 online in the official portal or in offline mode in a prescribed format available on the official website of IRDA, 3) File a omplaint before the Insurance Ombudsman concerned, 4) File a complaint against the concerned agents for ...ReadMore
Health insurance
Can i claim my remains medical expenses bill to my health insurace company if I received partial fund from chief minister relief fund. Suppose my total medical expense is rs 750000 n I received 200000
2 months ago
A. Dear Client,
In the situation, when your medical expenses are more than the sum you received from the CM's relief fund which is insufficient to cover your medical expenses and you are a policyholder of the health insurance policy of an Insurance Company, then you can opt for reimbursement for the balance amount from the said insurance company provided your claim covered by the sum insured under the said health insurance policy. The claim-filing process typically remains the same, for all insure ...ReadMore
Insurance claim
I had taken insurance policy while purchasing a commercial vehicle its recently met with Accident and its under repair from past 40days and i claimed for insurance policy under loss of employment. C
2 months ago
A. Dear Client,
The Motor Vehicles Act, 1988, makes the insurance of motor vehicles compulsory. The owner of every motor vehicle is bound to insure his vehicle against third-party risk. It covers the vehicle for damages against accidents, fire, natural disasters, and theft among others, and also covers any injury to the owner. It also covers any damages and injuries caused to the third party. A personal accident insurance policy provides protection against death, permanent total or partial disabil ...ReadMore
Insurance fraud
We had a insurance back in 2021 .My father got a call from a company One-Day .they said that you will get back your insurance money if you pay 40k when my father paid that they say now you need to pa
3 months ago
A. Dear client,
Section 45 of Insurance Act provides that an insurance policy cannot be avoided after expiry of three years on the basis of mis-statement, or untrue statement, unless insurers are able to establish;
1. That the statement was inaccurate or false;
2. That such statement was on a material matter or that the statement suppressed facts which was material to disclose;
3. That the statement was fraudulently made by the insured;
4. That the insured knew at the time of making the statement t ...ReadMore
