Mediclaim Insurance Pol No- 154302/48/8500001477 : period 31/03 - 30/03 .Ranaghat Branch.
I have started my mediclaim insurance since 02 . In the year 09 i have issued a cheque in favour of NIC ltd on 16/03 for renwal premium of 10 which will be started from 20/03 . But unfoortunetly NIC, Ranaghat br informed me on 31/03 that your cheque has been dishonour due to signature mismatch although i had a huge balance in my account and on that day i have deposited renewal premium by cash. Suddenly on 10-09-09 my wife feel some pain problem in her leg and as a result of this i have admitted her in Appolo, Chennai on 14-11 and lodge a cash less claim but NIC deny and informed that " the liability of the insurance company under this policy is not determinable at present from the details provided to us regarding the history of the insurance and diseas. Cashless facility cannot be granted under clause 4.1 (pre-existing illness)." However after returning from there i have submitted a claim to NIC Ranaghat Br. as per NIC rules and regulation on 27/11. Thereafter after writting 4 letter to NIC, Ranaghat Br. and Medsave Healthcare (TPA) Ltd. regarding status of my claim they (TPA) informed me on 16/04 that " the claim was rejected under clause no. 4.1 (pre-existing disease) of the pol. Asper records available with us the insured's mediclaim policy is fresh and effective from 31-03 ". Now my question is that can insurance co. deny my claim only for 12 days gap in depositing renwal premium and who is reponsible for such 12 days delay .if they informed me earlier then there was no such delay. I think only for that ground ins.co. can't reject my claim because i have been running my Mediclaim insurance policy for last 10 years and i want justice for that. Pl. help me.
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