Consumer hasn't been paid medicalaim
Pranav S. Thakkar
(Querist) 09 January 2013
This query is : Resolved
Dear Sir,
Here, In this case, The client who is consumer of An Insurance company of Medical Calim, Escape from its Liability to pay the amount to a consumer.
Fact is that, The company EMRI 108, had an employee. So, on joining , EMRI 108, gave benifit of Medi Claim Insurance Policy from Chola mandalam, and Company paid insurance premium on behalf of this client that is employee of EMRI 108.
A health Cards isssued to Client and his family membes his father and mother. Because it was under Group Policy. But original policy was kept with EMRI 108. So, the client was told to submit claim form Directly if any of claim anytime in future for medicalim.
After joining, the company, Client's Father had to gone through surgery, so, He asked for the claim to EMRI 108 and As EMRI 108 guided, they submit the original claim from with original Documents to the office. The EMRI 108 did not gave any reciept of revieving the original claim form. So, my client had no proof to prove that The claim form is given to EMRI 108.
Then, Having faith to company EMRI 108 N CHOLAMANDALM INSURANCE COMPANY PVT LT. and waited for allotmnt of amount of mediclaim. But Till 19 months my client not recieved any amount of claim. in e mail transections there was not satisfied answer of recieved the claim form.
So, my client filed case against both Companies. then judge asked for enought evedance, so the client asked for claim from to produce to both companies as per, NOTICE under ORDER 11, RULE 16,CIVIL PROCEDURE CODE 1908, & SUBMITTED COPY OF NOTICE AND R.P.AD. SLIP OF SENT NOTICE, TO THE DISTRICT FORUM. So, it was time to wait for the document, then to do appropriate Order.
Any of company, did not produce document, that was Claim Form,
Here, Court had to favour of Client. But they unfavour of my client n Dismissed the Complaint.
Now, here, Metter is filed by other Advocate n given to registrar in State commission now it is on Admission Satge, I can find out, another Law points to add in this appeal that is drafted by other advocate, so i am now to proceed in this appeal as this Appeal is given to me. So I need to add some more grounds to admit appeal. So, Is it possible, to add ground of appeal on admission stage?
Pl. Guide me any to add some new grounds in this Drafted appeal, if possible?
ajay sethi
(Expert) 09 January 2013
without going through the judgement and draft appeal to be filed by you no lawyer can suggest additional grounds to be added by you
R.venkatesh Naidu
(Expert) 15 January 2013
before filing your complaint you must receive the claim form by way of right to information act,they only you should go to file the complaint.
it is ok. now you can send a petition under rti because, that company has regulated by government. after receiving the details you can file a suit for recovery of money in civil court
