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Against improper insurance billing


23-Nov-2023 (In Criminal Law)
Hello I recently got cataract surgery for my mother done in delhi. The company sent an initial amount to the insurance company without mentioning the cost of lens. Insurance company approved the full cost. Now after the surgery , the the hospital send the bill again and insurance company found the lens bill too high and didn't pay the full amount. I have to pay a lot of money because of this. So i want to seek help as I think I have been cheated.
Answers (3)

Answer #1
771 votes
First of all rather than going legally you should serve them a legal notice and in that notice you can write that either pay my money or face legal action which will be at your own risk. After that if he fails to give you a satisfactory reply then you can anytime file a recovery suit in the court to claim your money back along with compensations.
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Advocate Jitender Singh

Adv. Jitender Singh

LawRato Delhi | 1000+ Answers
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Answer #2
910 votes
First and foremost you must lodge your grievance against the insurance company and highlight to them that why you are still eligible for the payment of the lens bill. if the insurance company still did not release the withheld amount for lens bills, then you have option either to approach the respective consumer forum or insurance ombudsman. The selection of the above mentioned to forums will depend upon the facts of the case as well as the amount withheld by the insurance company. Filing a criminal complaint may not be of much use to you. you may pursue your remedy against the insurance company before the consumer forum or the insurance Ombudsman.
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Advocate Ankush Mahajan

Adv. Ankush Mahajan

LawRatoDelhi | 25+ Answers
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Answer #3
993 votes
If the company has approved the full cost initially then. they cannot back out on the payment of the cost. Normally the insurance company initially ask from the hospital for an approximate expense and then gets the approval. if this has been done then you have been cheated and you can file a case against the company
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