Hello,
One of my friends was working with an organization as a junior officer. Her organization had taken out a mediclaim policy for all employees, including a premium for loading delivery cases. When my friend was hospitalized, she informed her employer over the phone. After being discharged and returning home post-delivery, the HR personnel of her organization asked her to submit all medical bills within 7 days from the date of discharge, which my friend complied with. Later on, the HR personnel realized that they had not provided the 'FORM' required for the claim submission. They then sent the FORM, which my friend received after the seven-day deadline had passed. Despite being confined to bed, my friend somehow managed to complete the formalities, including obtaining the doctor's signature, and sent the documents through a courier to her organization. The HR personnel then submitted all the papers to the insurance company. However, the insurance company is now stating that the reimbursement of medical bills will be rejected due to the delayed submission. My friend's argument is that since all medical bills (excluding the FORM) were submitted on time, the HR should have forwarded them to the insurance company promptly to avoid any delays. It was the fault of the HR personnel for not sending the FORM on time. As her medical bills have not been approved by the insurance company yet, my friend is questioning if she can take legal action against her organization in light of the situation. If so, where should she approach? Would the Consumer Court deal with such matters? I would appreciate urgent advice on this matter.
Regards.
One of my friends was working with an organization as a junior officer. Her organization had taken out a mediclaim policy for all employees, including a premium for loading delivery cases. When my friend was hospitalized, she informed her employer over the phone. After being discharged and returning home post-delivery, the HR personnel of her organization asked her to submit all medical bills within 7 days from the date of discharge, which my friend complied with. Later on, the HR personnel realized that they had not provided the 'FORM' required for the claim submission. They then sent the FORM, which my friend received after the seven-day deadline had passed. Despite being confined to bed, my friend somehow managed to complete the formalities, including obtaining the doctor's signature, and sent the documents through a courier to her organization. The HR personnel then submitted all the papers to the insurance company. However, the insurance company is now stating that the reimbursement of medical bills will be rejected due to the delayed submission. My friend's argument is that since all medical bills (excluding the FORM) were submitted on time, the HR should have forwarded them to the insurance company promptly to avoid any delays. It was the fault of the HR personnel for not sending the FORM on time. As her medical bills have not been approved by the insurance company yet, my friend is questioning if she can take legal action against her organization in light of the situation. If so, where should she approach? Would the Consumer Court deal with such matters? I would appreciate urgent advice on this matter.
Regards.