Insurance company denying to pay the cost
N.J. MISHRA
(Querist) 11 June 2013
This query is : Resolved
Dear Member please guide;
one of our employee suffered some psychological disorder; hence, admitted in the hospital. He due to nature of sickness damages hospital property worth Rs. 50,000/-. Now the Insurance company denying to pay the said amount and said that person will borne the cost himself inspite that we have explained to them that the such action arises in view of sickness and the person has not done this intentionally. What will be the legal implication if the Insurance company refused to pay the amount.
Rajendra K Goyal
(Expert) 11 June 2013
The terms and conditions of the Insurance Policy are to be seen. Whether the insurance policy covered third party claims with the medical claim? Damages to hospital property is not an expanse on medicine or treatment as is generally covered in medical insurance cover.
Raj Kumar Makkad
(Expert) 15 June 2013
The terms of the insurance have to be read before replying your question.
