Insurance company denying to approve maternity reimbursement

Hi, I have medical insurance for my family ( wife, son (8), daughter(2) and myself) from Mediassist , through my company Hewlett Packard enterprise, Bangalore. My wife is expecting our third child now, I have claimed maternity insurance only once till now ( that is for my daughter). The insurance document clearly states that "Maternity claims are eligible for maximum of 2 instances per employee " and I have till now claimed maternity benefits only once. For my son I have not made any insurance claim. Now insurance company is refusing to reimburse maternity claims for my second claim , saying that since this is my third child I cannot claim any insurance. Please help me or advise me as to what steps I can take against this behavior from Mediassist insurance company. I have paid all premiums till date and also have top ups till 8 lakh limit .

Answers (1)

251 votes

Hi, If the insurance document clearly states as you mentioned above then they can not reject your claim for your third child which would be 2nd time that you are trying to claim.You have grounds to initiate legal action against medi-assist but that should be taken less than 30 days in most of the cases.

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