Legal Question in Consumer Law in India

I had taken a health insurance policy from Star Insurance Company Jayanagar Bangalore on 19th Dec 2013. The company representative did not tell me anything at the time of giving cheque and he disappeared after the cheque was encashed. Unfortunately on 12th January 2014, i had undergo an emergency operation for appendicitis in bangalore. After the surgery, i collected my medical form (my age 57) and submitted immediately alongwith my claim. The Star Insurance has rejected my claim with the reason that any claim within 30 days of the policy will not be entertained. Kindly advise whether this is acceptable reason and all insurance companies have same policy? Kindly also advise me what is my recourse against the Star Insurance Company.


Asked on 4/08/14, 9:00 pm

2 Answers from Attorneys
anuradha Dixit +9312411481 dixitlawfirm

the pvt company/tpa have many clauses to save them from giving claims.was predisease covered in your policy if not then they have rejected the claim on this ground..

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Answered on 4/08/14, 9:06 pm
Fca Prashant Chavan Expert Edge LLP

09.04.2014

Dear Sir / Madam,

The Star Insurance Company is legally bound to acknowledge, honour and settle your claim. No, the Company ought to have specifically mentioned in the terms and conditions of the Policy, that claims if any will only be effected for any medical illness after the first month. You should tell the Star Insurance Company that delay in issuing the receipt is the Company's problem and you are not to be penalized for it.

Regards,

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Answered on 4/08/14, 9:10 pm


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