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Rejection of medical claim policy on false background


In Insurance Law
Dear sir I have easy health policey of hdfc life which is life insurance policy having benefit of daily cash benefit of hospitalization. I was admitted in hospital due to intestinal obstruction for 3 day ICU and 4 day in pvt room and my hospital bill was 46000/ and company rejected my claim on 3 points, frist point was that in hospital indoor record my date of discharge was different, on this point when I asked hospital they said it's manual mistake and in every document date of admission and discharge is correct. Second point was in hospital registration certificate renewal was not in claim year but when i review hospital registration certificate shows renewal stamp of this year but stamp was little bit light so this point is also incorrect. Third point was my treating dr is not RMO of that hospital when I asked hospital for the same hospital told me that my treating dr is on call basis and his name is also mentioned in registration certificate of hospital so this point is also wrong.

Answers (3)


52 votes

Please file a consumer complaint before district consumer forum against repudiation of claim. At the time of filing of complaint, you may describe all the facts and submit all the supporting documents.


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113 votes

Well,
At this stage as you are very much clear that the POints raised by the organisation is to be challenge before the court then you are requested to come after consultation, alongwith an APpointment and the relevant document

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232 votes

Hello, basically insurance companies while selling the policy get reluctant bout when it comes to give benefits they scrutinize the docs. like anything, in your case they are just trying to save themselves to pay you the claim, go to ombudsman or you can give them proper legal notice, and after not getting any relief over all such exercises you can go to District consumer forum.


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