Insurance Samadhan received mail from one Corona Positive Recovered Patient who was struggling to get his claim. He wrote to us for help as he was not getting any response from his standalone health Insurance company. We immediately got into action and asked him to send all the documents on our mail. After receiving the documents, we examined the papers and gathered all the details of the case for taking up with the insurance Company.
We realised that the Patient could not get the Cashless facility due to restrictions between the Hospital and the Insurance Company in regard the cashless facility. The total claim on account of reimbursement was made for Rs. 3 lacs. The main reasons for the delay was non providing of Indoor Patient Documents by the Hospital. When representing the case with the Insurer, we highlighted the instructions of the Government of India in regard to restrictions on sharing of Indoor Claim Papers of the Covid patient. We also gave the declaration that all the original papers including bills will be provided to the insurance company after the lockdown or situation gets normalised. We have also arranged affirmation that if declaration is found untrue, the insurance company is liable to recover the entire claim amount. At last we have requested the Insurance Company to follow the guidelines of insurance regulator IRDA for expeditiously handling and settlement of claim.
Within 5 days of representing the case, the insurance company approved the claim as per the terms and conditions of the policy. The policyholder was very happy and has conveyed his thanks for prompt intervention and help extended to him by the Team of Insurance Samadhan for early settlement of his claim. We have not charged any fees from the Covid Recovered Patient under the corporate social Responsibility (CSR) policy of the company and support for the Nation’s fight against Corona Virus.
In case you are feeling problem in handling your insurance claim with respect to Health Insurance Claim or Life Insurance Claim please feel free to contact Insurance Samadhan team and we shall be happy to assist you with your complaint.
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