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Asso.prof.(commerce & Management)
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Finance Manager
Pon1965
Construction
+2 Others

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Hi All, I am facing a tough time with my companies Insurance Partner.I had my first child recently.I was very much relied on Insurance Money.But when I submitted the Medical Bills , I was shocked to listen that the Insurance company does not have any records of my wife with them & their records show still I am single.......I was married about 2 years back.I have updated all my family details in my company portal.But as per our HR, I should have submitted an Hard Copy of martial status & my dependents, which I was not knowing. Now Insurance people are saying that the as per the Bills date your wife was not covered under insurance. But as per the policy I read that it covers Spouse & Children by default.
I want to know how I need to proceed & my get my insurance money, which I feel is my right.

From India
Did you check the your dependents at the time of policy period.
From India, Pune
I understand your pain, but you would have checked beforehand the policy before sending the claim. It is the duty of the HR to enquire the family (dependent) details of all their employees before proceeding for any Insurance policy or renewal of the same.
In your case the HR is correct, it is not only updating the profile in Company portal but also intimate the HR about your marital status in writing with evidence so that they can change in all statutes. Please also change the nominations of all the statutes with due consent of your HR. Please treat HR personnel as your best friend and share things for which you need assistance/advice don't hesitate.

From India, Ahmadabad
Most of the insurance companies are operating thru TPAs. The TPA issues identity card to all the insured. Did you not check? Pon
From India, Lucknow
Dear,,

Not only for medical insurance, for that matter any insurance a proposal form (in this case to include addition to the family members), payment of relevant insurance premium (in this case an incremental premium to cover the spouse, child to be born etc.) and furnishing all relevant documents as the insurance co. requires only after compliance of these formalities the insurance co. issue premium receipt, either the amendment to the original policy of the concerned or a fresh policy. Failing which insurance reimbursements cannot be guaranteed. Mere updation HR portal will not suffice. And as Pon said every insured are issued a photo id card which itself would ensure eligibility. However I still have a hope if and when the HR portal is updated with family details is't not the responsibility of the HR to obtain all relevant documents and do necessary coverage required ? I think they are evasive. Therefore, atleast during pre-natal check ups the queriest should have checked up these requirement. I afraid it's difficult to make the insurance co to heed.

From India, Bangalore
Hi All,
Thnx for your suggestions.Fianlly I got my claims, I should appreciate our HR for the brilliant job.
First they owned up the responsibility & got it done.
Final Word : Good things do happen in India.

From India
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