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ravi (engr)     07 April 2019

Insurance claim denied due to 4 outof 17 days uncovered

A corporate-co employee Insurance claim enables to claim 1st claim without any waiting period.On the month of 1st premium paid, if a member was admitted to Hospitalization 4 days prior to start of the policy and extends to 17 days. Shall the claim be paid for full 17 days or (17-4=) 13 Days. If insurance co says not possible to claim any day, because of admission done before start of POLICY, what shall one can do, i.e can any civil case be filed. Orelse what are the possible ways to get the claim amount?

It being a corporate-co policy, No policy No. is given to employee, so I do not think that it can be taken to IRDA ombudsman/ complaint. 

Does the Insurance ACT allow to claim the amount leaving the 4 uncovered days?
Please advise Immediately. Can you suggest any performance oriented civil lawyer in Chennai.



Learning

 1 Replies

Isaac Gabriel (Advocate)     25 August 2019

File a complaint before the consumer redressal Forum where the issue could be dealt with thread abd bar. As the period falls withion the polcy period, you could get redressal.It is no matter whether the policy number was assigned or not.


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