Lately, a majority of private hospitals in the state are declining cashless treatment facility for Covid-19 to mediclaim policyholders
Vadodara: With the new notification giving a protocol for admission of Covid-19 patients and inspection teams verifying if admissions were justified, many may be concerned about the fate of their medical insurances if the notification is made a ground for denying mediclaim.
But experts and lawyers say that insurance companies cannot turn down claims on such grounds.
“The civic body has only issued guidelines for regulating the availability of beds in such times. Since it is not a law, the insurance companies cannot use them for rejecting the claims,” said prominent lawyer Jaideep Verma.
Vadodara: Government-owned Madhya Gujarat Vij Company Ltd (MGVCL) allegedly went back on its word and plunged an elderly couple into darkness by snapping their power connection on Tuesday evening.
Facing litigation in Vadodara District Consumer Disputes Redressal Forum, MGVCL’s lawyer had assured Saroj Agrawal, a resident of Akota, last month that until the next hearing on Wednesday their electricity will not be disconnected. Agrawal had filed a complaint in the consumer court on February 10 as MGVCL had sent her a notice in January stating that they have an outstanding electricity bill of over Rs 1.65 lakh from 2011.
In 2011, MGVCL had sent a bill of Rs 1.8 lakh with allegations of electricity theft. When Agrawal had taken up the issue with higher-ups of MGVCL, the dispute was settled when she paid Rs 30,460. Despite the settlement MGVCL on January 28, threatened Agrawal to make the payment or face disconnection. When Agrawal’s representations failed, she approached the cons
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VADODARA: Did a third-party administrator (TPA) reject your insurance claim or deduct money from your claim amount under some or the other clause? Well, you may now hold the TPA responsible for going beyond its role and taking arbitrary action by rejecting your claim.
Recently, in at least half-a-dozen cases, the consumer court ruled in favour of the insured person just because the TPA had rejected their claim, citing the regulations of Insurance Regulatory and Development Authority of India (Third Party Administrators - Health Services) Regulations, 2016
The Vadodara district consumer disputes redressal forum (additional) referred to regulation 3(2) of the rules which stated that ‘TPA shall not reject or repudiate any of the claims directly’ and ‘shall not directly make payments in respect of the claims.’