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Health insurance claim rejected due to hospital misrepresentation, like they charged differently at the same time of admission duration for the same treatment. What to do in this scenario.

Posted 1 week ago


A. Dear Sir,
You may approach Insurance Ombudsman or Consumer Court.

I could have explained more if background is known to me. If background is made known in full then legal experts will be in position to understand correctly. Moreso, the background must be in brief.

Please give me FIVE STAR if satisfied by my answers.
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Anonymous

2014 ರಲ್ಲಿ ಆಗಿರುವ ಘಟನೆ ಈಗಾ clime ಮಾಡಿಕೊಳ್ಳಬಹುದಾ

Posted 3 weeks ago


A. Dear Sir,
It is too late but if there are grounds to justify the delay you can approach Magistrate Court and file private complaint and get it registered.

I could have explained more if background is known to me. I am at your service if you visit my office.

Please give me FIVE STAR if satisfied by my answers and you may approach me through Vidhikarya for further clarifications.
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I am leaving my current organization and 30th Sep'21 is my last day in the organization. I would not be joining any another organization. Hence, I would like to migrate the group health insurance (pr

Posted 3 weeks ago


A. Dear Sir,
You may approach insurance ombudsman if clauses of first policy allows such transfer from one policy to another.

I could have explained more if background is known to me. I am at your service if you visit my office.

Please give me FIVE STAR if satisfied by my answers and you may approach me through Vidhikarya for further clarifications.
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I purchased a term insurance policy in July 2018. I did not go into the details then as i had already disclosed all the true details in good faith to the insurance exec and the doctor. When i went thr

Posted 1 month ago


A. Hi,
You have to bring this to their attention. It is difficult to claim the insurance in case of any such errors and the company will try its level best not to approve the claim. Please contact them and for legal advice, please contact a lawyer.
Please rate my answer
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Our Health insurance renewal premium has been hiked by almost 3-fold. Only reason being given as age slab change from 60 to 61. can we anyway challenge this? The insurer is claiming they has regulator

Posted 1 month ago


A. IRDAI does allow some room to the insurer to change the premium for health insurance following some guidelines issued by the IRDAI. You ask your insurer that under which rule they have changed it and once you have the rule then we can evaluate whether to challenge it in the court or not.
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Anonymous

My cousin was taking medication for schizophrenia from 2018 end. She bought health insurance in 2021, but forgot to disclose about schizophrenia while buying health insurance. She had typhoid and has

Posted 1 month ago


A. Hi,
This may amount to fraud from your side and will be difficult to get your insurance sanctioned. Since you conceal the fact that you have been taking medication for schizophrenia since before the period of insurance, the company can use it as a defense against your claim.
Please rate my answer
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I had purchased Money Back Plan (New Bima Bachat Table 816) from LIC in October 2014. The agent gave me 100% fake & inflated figure of Loyalty Addition of Rs. 7,50,000 (Bonus - Notional Profit), to be

Posted 2 months ago


A. Hi,
LIC has to take responsibility. You can sue LIC as there is a principal-agent relationship between LIC and its agent and the principal is responsible for the actions of their agent.
Please rate my answer
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For medical insurance, I've asked my hospital to provide their registration number or ID, however, I was quiet shocked to hear that they do not have license or they did not renewed it but they are per

Posted 2 months ago


A. Dear Sir,
You have several options and you can get huge compensation from them. First lodge a complaint with the Police. Secondly send complaint to Medical Council of India. Thirdly, you make it viral on social network and approach consumer Court claiming compensation.

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There was one finance company back in 2008 P, they make member, in that we have to submit some money to company they will return double stake in 5 years, but that company closes back in 2010 owner arr

Posted 2 months ago


A. Hi,
You are responsible only if you induced them with mala fide intention to invest the money in the company. But if you did not have any such intention, you are not responsible and have no liability. You have to prove it in court.
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Lucem  Leg
Lucem Leg
Ayantika Mondal @ Prime Legal
Ayantika Mondal @ Prime Legal
I bought a Health Insurance in name on my mother in July 2020, I told agent that my mother has Blood pressure. When I received policy document I didn't read it properly, this year in April 2021 my mot

Posted 2 months ago


A. Hi,
Health insurance plans change depending on the organisation. The claim cannot be denied merely due to medical inadequacies; nevertheless, the policy must be studied carefully. Pre-existing illnesses, such as high blood pressure, are often not covered by insurance providers, thus any medical expenditures incurred as a result will not be reimbursed. This is something you should discuss with your doctor.
Thank you very much.
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