Legal Question in Consumer Law in India

Claim:Medical Policy

Hellow,

I have been provided a family health plan policy by my employer thru New India Assurance company. All the procedures will be administered by the Third pary administratior: FHPL.

My father was hospitalised due to serious viral fever and in this case he is elgible to reimburse.

I have sunmiited the claim along with all the required details and docs to FHPL within the submission period, But I missed to give my policy number correctly.

FHPL people asked me for the correct policy number.

I have submitted the correct policy number after two weeks.

But still the claim is rejected by insurance company.

What could be done?

Bhaskar


Asked on 2/06/07, 12:43 am

2 Answers from Attorneys
Mahesh Gupta Medico-legal Advocates and Consultants

Re: Claim:Medical Policy

You should send a notice to the company and the third party administrator asking the reason for refusal of claim. If theydon't reply or if the reply is not satisfactory, file a complaint with the concerned Consumer forum.

**********

Dr. M C Gupta

MBBS [AIIMS], MD, Internal Medicine [AIIMS], MPH [San Carlos Univ.]

LL.B. [DU], LL.M. [KUK]

Fellow, United Nations University

Ex-Professor & Dean:

National Institute of Health and Family Welfare

Ex-Additional Professor:

All India Institute of Medical Sciences

Advocate

Health and Medico-legal Consultant

Member, Supreme Court Bar Association

Member, Indian Law Institute

[email protected]

http://www.medindia.net/myhome/mcgupta44

www.writing.com/authors/mcgupta44

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Answered on 2/06/07, 8:51 am

Re: Claim:Medical Policy

Your question is incomplete.You have not stated the ground on the basis of which your claim was rejected.

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Answered on 2/06/07, 12:26 pm


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