Injustice by United India Insurance Company in my Late Sisters Mediclaim
My sister "Baunanee Saha" was a kidney patient on dialysis since 2008 Nov. She had a Mediclaim policy from United India Insurance since April 2004. They paid for her dialysis till 2011 and also for her kidney transplant in 2011. However in 2012 she was hospitalized with an infection post transplant and the Insurance company refused to extend cashless facility at Fortis Vasant Kunj.
They initially asked us to claim reimbursement for the 2.71 lakhs bill at Fortis. Once we put the bill for reimbursement, they sent a letter giving notice for cancellation of policy saying the policy was no longer viable as claim ratio was too high. The shock of this letter was so much that my sister died with a week (on 21st July 2012).
Can an insurance company refuse to pay when amounts claimed are within the coverage limit? Can they cancel a policy because it affects company profitability?
I was so upset, I filed a complaint with District Consumer Forum against the MD of United India Insurance Company Ltd.. There the opposite party tried every trick in the book to delay the process. In fact their lawyer told me that even if we win the case they will appeal in state commission, National Commission and Supreme court and that we should withdraw the case since we had made the MD the opposite party and it was now about their prestige. I then paid Rs. 30,000 and hired a private lawyer since it was getting difficult to fight this case alone.
They changed 3 lawyers, sometimes the lawyers never showed up etc. Finally when the judge said he will decide the case in the next hearing ex-parte, the lawyer went to the state commission and got a stay. The case is still dragging on, although its almost 3 years now. It was my Sisters 3rd Death Anniversary yesterday. I don't know when the case will get decided and if United India will abide by a District Courts judgement...
Looks like its going to be a long haul.
Please help us get justice.
Regards,
Shantanu Saha more
They initially asked us to claim reimbursement for the 2.71 lakhs bill at Fortis. Once we put the bill for reimbursement, they sent a letter giving notice for cancellation of policy saying the policy was no longer viable as claim ratio was too high. The shock of this letter was so much that my sister died with a week (on 21st July 2012).
Can an insurance company refuse to pay when amounts claimed are within the coverage limit? Can they cancel a policy because it affects company profitability?
I was so upset, I filed a complaint with District Consumer Forum against the MD of United India Insurance Company Ltd.. There the opposite party tried every trick in the book to delay the process. In fact their lawyer told me that even if we win the case they will appeal in state commission, National Commission and Supreme court and that we should withdraw the case since we had made the MD the opposite party and it was now about their prestige. I then paid Rs. 30,000 and hired a private lawyer since it was getting difficult to fight this case alone.
They changed 3 lawyers, sometimes the lawyers never showed up etc. Finally when the judge said he will decide the case in the next hearing ex-parte, the lawyer went to the state commission and got a stay. The case is still dragging on, although its almost 3 years now. It was my Sisters 3rd Death Anniversary yesterday. I don't know when the case will get decided and if United India will abide by a District Courts judgement...
Looks like its going to be a long haul.
Please help us get justice.
Regards,
Shantanu Saha more
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Oct 31
Why don't you try to get the media into this specially channels like times now and Aaj Tak that seem to be interested in taking up such issues. It is time that these insurance companies are taken to task. I would also suggest you writing to the various trade associations all over India as most of the trade community are major customers for the insurance companies. You can send this information to all the other private and govt insurance companies as this will result in them informing there clients thereby spreading the word faster. I am sure you will take this matter to the end and assure you that soon justice will be done. Good luck more
Oct 11
Hi, Drag these cutthroats to consumer court and inform the case points to local journalists/ tv along with date of hearing. Demand a compensation of 1 crore for cheating. more
Jul 30
Santanu!! I can understand the pain of the process.... but please please donot give it up...such cases only will make govt and companies hear us .. lets try to use media to spread this awareness.!!! Warm regards Vikas Vande Matram!!! more
Jul 26
Santanu, you may now have no option to go to Ombudsman as it is in Consumer court. I may suggest that it is to fought till the end and I wish you good luck. more
Jul 26
