Health insurance claim query
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
2 years 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.
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Ayantika Mondal @ Prime Legal
LIC Agent: Misleading, Cheating & Criminal Breach of Trust
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
2 years 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.
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Ayantika Mondal @ Prime Legal
Vaidehi Samant
Hospital performing surgeries without any valid registration
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
2 years 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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What to do if somone put irrelevant 420 on you after 10 years?
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
2 years 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
Ayantika Mondal @ Prime Legal
Jagannath S Pawar
Will the Health Insurance Claim be rejected due to BP
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
2 years 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.
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Ayantika Mondal @ Prime Legal
Insurance claim We were supposed to claim his group term insurance I don't who he has kept nominee and his office people doesn't reveal that.
My husband died and we have no childern. We were supposed to claim his group term insurance I don't who he has kept nominee and his office people doesn't reveal that. My in laws are divorced and never
2 years ago
A. Hello Ma'am
It would be suggested to contact senior officers of the insurance company, write them a letter explaining your issue and take action in this regard. Also after your husband death you have right to claim his property.
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Ayantika Mondal @ Prime Legal
Lucem Leg
Advocate Sinjari Bandyopadhyaya
LIC DEATH CLAIM IN SUICIDE
On July 10th my mother committed suicide in her mother's home while she was alone at home by using kerosine oil and lighter. She was suffering from mental illness where she used to hear people talk ab
2 years ago
A. First by law you can not demand any compensation. And any benefit. Because your mother to be suicide. Either any policy holder can not sucide if the policy holder takes the sucide. His legal heirs can not challenge any benefit which give by lic and post office.
You should be contact to the office. And after takes staps.
Accident death naturally death. Any suddenly ill.
Some death are decried in the policy. Then the policy holder heirs takes benefit.
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Pardeep Kumar Dhiman Dhiman
Insurance act 2015 and nomination
My daughter has expired during pregnancy( child was alive) and she was working at that time. Company had a term insurance policy under her name And term insurance is taken on the month of August arou
2 years ago
A. Dear Sir/ Madam
Unless a legal obligation has been imposed the property of the deceased shall be received and held by the nominees and not the heir.
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Ayantika Mondal @ Prime Legal
Non Payment of full amount on maturity by Kotak life insurance as per bond terms
Dear Sir/Madam, I am not satisfied with the response from Kotak life insurance on maturity benefits as they have not paid as per bond paper terms and conditions. As per ter
2 years ago
A. Dear Sir,
Such instances are more in Private Sector Banks. Better you approach ombudsman of insurance and if not resolved in your favour then approach consumer forum if not resolved then finally you may approach High Court.
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Medical claim got Repudiation for Crosspathy, what to do?
As per policy, crosspathy is not payable .Hence the claim is being denied under clause no 3.25 of the policy. MEDICAL PRACTITIONER is a person who holds a valid registration from the Medical Council
2 years ago
A. Hi,
If the policy was repudiated for crosspathy, then you will have to approach the consumer forum, and present your case that the repudiation was not valid as the clause of crosspathy was not violated by you. Please consult with an advocate personally, he will advise you further.
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Ayantika Mondal @ Prime Legal