Medical Insurance & Case Papers

If one has medical insurance and is hospitalized for some major problem leading to surgery or other medical actions, and if one claims the medical insurance, the insurance company insists that all the original documents, reports and films for USG, MRI, X-rays, etc need to be submitted along with the claim for the reimbursement of these medical expenses to be accepted by the insurance company.

What do they do with the original documents collected? Destroy them later, may be.

But if the patient develops some other serious problem at a later date, the patient only has the photocopies, which are not at all useful. Mostly, these photocopies are taken by the hospital itself (who cares a damn for the patients anyway, and are mostly interested for getting the money, which they get from insurance companies), the hospitals are totally careless in taking the photocopies. If a patient is admitted at a later date for extended problems from earlier hospitalization, the very same hospitals blame the patients due to poor quality of the photocopies.

I understand, that Hon Supreme court in one of it’s verdict has said that any citizen can taken multiple mediclaim policies from different insurance companies. In such a case, the person is paying multiple premia for the different insurance policies taken.

After the first hospitalization, when the claim is to be submitted, the patient many times finds, that all the medical problems faced by him/her during that hospitalization, are not covered in each of the mediclaim policies taken.

In such a case, he/she tries to find the policy under which he/she can get maximum benefits.

Unfortunately, the problems for which claim cannot be submitted for one such policy selected, are covered under other policy.

But because all the original documents and reports are handed over by the hospital to the medical insurance company, the patient finds that this claim cannot be even made by him/her.

It is high time, that the mediclaim companies respect the verdict of Hon Supreme Court, and allow the patient to submit more than one claim to different insurance companies, for which they must stop asking for the original documents and reports, which are only grabbed by them so that the second claim cannot be made by the patient. An anti-patient attitude.

The hospitals also must be banned from directly handing over the originals to the insurance companies because the insurance premia is not paid by the hospitals. If insurance companies have some such clause for the hospitals to follow, that MUST be removed legally.

If one is making premia payments to multiple policies, one MUST be allowed to claim advantages available with each of such policy, for which the patient MUST be allowed to keep the original documents and reports with him/her, and submit only photocopies attested by the hospital o the insurance companies.

Can the health ministry do something in this respect, especially for senior citizens? more