Legal Question in Insurance Law in India
case of stop payment of cheque
i got operated at a hospital for which pre approval of rs 15000 was obtained from reliance by the hospital as I had got a mediclaim of rs 500000.I was discharged by the hospital after operation .The total bill was rs 16750.When hospital asked approval for additional ammount reliance company cancelled the original approval of 15000 also stating that approval was given for wrong disease which I was not having .Neither the hospital took pain to see whether they have got the approval for disesase which they were treating.Then hospital told me to give two month post dated cheque of 02/12/2008 of Rs16750 & file reimbursement of operation expenses from reliance & verbally said that if I get claim then they will cash the cheque otherwise not.They also issued receipt of this cheque on 28-09-08 mentioning date of cheque as 28-09-08 on the receipt.After I filed claim to relance they shockingly rejected my claim stating that the disease is exsiting from 4 years as per thier doctor.Now pl advise what to do against reliance & if hospital tries to cash that cheque.I have directed my bank to stop payment of this cheque
1 Answer from Attorneys
Re: case of stop payment of cheque
a) the hospital is entitled to be reimbursed;
b) you may need to challenge Reliance's decision rejecting your claim.
litigation may be expensive.
You may directly file a complaint against insurance company with the "Ombudsman" under IRA or before any other appropriate authority.
The last resort may be to file a complaint in district consumer court.
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