Hello
One of my friends was working with an organisation as junior officer. Her organisation has taken the mediclaim policy for all employees including premium of loading of delivery cases. When my friend was hospitalised, she telephonically informed her employer. After she was discharged and went to home after post delivery, HR people of her organisation asked her to send all medical bills within 7 days from the date of discharged which my friend complied with. Lateron, HR people realised that they have not sent 'FORM' under which the claim is to be submitted. They then sent FORM which my friend received after expiry of seven days. As my friend was confined to bed, she some how completed the formalities including obtaining of Doctor's signature etc. and sent through courier to her organisation. HR people then submitted all papers to the insurance company. Now insurance company is saying that reimbursement of medical bills will be rejected on account of delayed submission. My friend's contention is that when all medical bills (excluding FORM) have been submitted in time, HR would have submitted the same to the insurance company to avoid delayed in submission. It was a fault of HR people that they would have forwarded the FORM in time. Her medical bills is still not passed by insurance company. Can my friend take a legal action against her organisation in view of the above? If yes, where she approach? Whether Consumer Court deals with such matter.
Kindly advise me urgently.
Regards.
From India, Mumbai
15One of my friends was working with an organisation as junior officer. Her organisation has taken the mediclaim policy for all employees including premium of loading of delivery cases. When my friend was hospitalised, she telephonically informed her employer. After she was discharged and went to home after post delivery, HR people of her organisation asked her to send all medical bills within 7 days from the date of discharged which my friend complied with. Lateron, HR people realised that they have not sent 'FORM' under which the claim is to be submitted. They then sent FORM which my friend received after expiry of seven days. As my friend was confined to bed, she some how completed the formalities including obtaining of Doctor's signature etc. and sent through courier to her organisation. HR people then submitted all papers to the insurance company. Now insurance company is saying that reimbursement of medical bills will be rejected on account of delayed submission. My friend's contention is that when all medical bills (excluding FORM) have been submitted in time, HR would have submitted the same to the insurance company to avoid delayed in submission. It was a fault of HR people that they would have forwarded the FORM in time. Her medical bills is still not passed by insurance company. Can my friend take a legal action against her organisation in view of the above? If yes, where she approach? Whether Consumer Court deals with such matter.
Kindly advise me urgently.
Regards.
From India, Mumbai
My friend's company advised in writing that it was a responsibility of an employee to directly deal with the insurance company in the instant case. Company is not responsible. My querry is that when employee join any organisation, he is bound to take the mediclaim approved by the organisation and when employee leaves the organisation, mediclaim policy automatically lapse. So how an employee is responsible to directly deal with the insurance company when company was making payment of premium to the insurance company. Kindly guide me in the matter as I am thinking to advise my friend to file court case against the company.
From India, Mumbai
From India, Mumbai
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