Employer is refusing to pay the mediclaim insurance amount which was already been credited by the insurance company - CiteHR
Pvenu1953@gmail.com
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Suresh2511
Labour Consultant

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Hi,
This side Aruna, I am writing this querry to take expert advice from the professionals.
Case :- I am an ex employee of a real estate company. had served almost 3.5 years of services in HR Deaprtment. during my stay in the company i have raised the mediclaim ( which was provided by the company) for my father.The clim was successfully processed in the companies account amount INR 1 Lac.
On 15th April 2019, suddenly my employer forceing me to put down my papers. At the time of exit ( which was forcefully done by the employer) i have told by the company that at the time of F&F i will get my mediclaim too.
After the continous followup i have got my full and final ( Excluding Mediclaim) in the month of June 2019. When i asked y i am not getting my medicalim then the hr told me that you will get in some time. Just to save me, i have mentioned in F&F Settelemet receipt that " My Mediclaim is still pending".... Now my employer is refusing to disburse that, mediclaim amount and asking me to sign the fresh copy of F&F Settlement sheet (mention there is no dues are poending from employer side)
I Have refused to sign the fresh copy and started sedning them formal mail reminder.
Please sugget what should i write to the MD or the top level management so that i will get my mediclaim.
just to share top management and MD is also not in favor of paying the insurance amount.
Plz suggest what should i do...
Thanks
Aruna

Hi Aruna,
This situation needs to be handed subtly.
My point of view is that this amount cannot be demanded as a matter of right like salary. Mediclaim is a voluntary benefit offered by the employer and not a statutory benefit like Gratuity or PF. It is not part of your salary.
However you can request them through email to release the payment. You have not briefed why your employer forced you to submit resignation. When your exit is not smooth the probability of your request for mediclaim amount getting approved is remote.

Hi Aruna
Added to the above by any chance if you have contributed for the Mediclaim premium (Employee 50% +company 50% pattern as followed in some Companies) then you will have the rights for the claim. Else there will no validity.

The facts stated suggest that the action of the employer is unethical; you are entitled for the amount of mediclaim. The company cannot appropriate the same whatever be the context.
Aruna,
If your mediclaim insurance premium is your part of salary and or shown in your CTC, you are legally entitled to receive the mediclaim reimbursement amount.
1. If you have incurred / spent the hospitalisation expenses for your father's hospitalisation and submitted to insurance company thru your employer for reimbursement, you are eligible for the said approved amount.
2. You may write to the insurance company thru which your company policy is operational that the approved mediclaim amount is not reimbursed to you against the hospitalised claim of your father.
3. You have full right to register your complaint to Insurance Regulatory Development Authority (IRDA) giving full details of your case history. You will receive your claim without any delay.
4. Lastly, If nothing is materialized, you can finally write to the insurance company that you are not interested for reimbursement of your father's hospitalisation claim and hence return all your claim papers and let the insurance company take back the claim amount from your ex-employer.
Regards,
Suresh

Hi
In my view, you should get the amount from the company and if required you must take the legal route.
The money is not a claim made by the company but a mediclaim reimbursement of an employee. The company has no authority to appropriate money that does not belong to them.
If the company is adamant about not passing on what has been reimburse to you thorough them, I strongly urge you to consult a lawyer.
Best Wishes

HI,
Thanks for sharing the suggestions. I wrote a mail reminder again to the MD but no response from his side too. Now no one from the HR department are taking my calls nor even responding to my reminder mails.
Had a word with the insurance company, they are saying that i need to speak to the employer only.
This is unethical, that mediclaim was although not the part of my salary but that amount doesnt belongs to the company even.
To take that remibursement from the insurance company i have struggled a lot sothat i 'll get that amount but my ex employer is doesnt even care about it.
I really need help. Plz suggest what should be the next course of action.
Shall i send them the legal notice.
Plz suggest
Thanks
Aruna

Aruna,
I had suggest to write letter to insurance company and Insurance Regulatory Development Authority (IRDA) and not to talk to insurance company. They will reply to you officially. Also mark copy to your ex-employer.
Regards,
sna

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