If you and your family are covered by medical insurance, this information is beneficial to you. You must have often heard about medical insurance that in order to get a claim, it is necessary for the patient to be admitted to the hospital for at least 24 hours. The medical insurance provider is free to deny the claim if you are admitted to the hospital for less. But, according to a Consumer Forum order, the beneficiary of Medical insurance has the right to accept the claim within 24 hours. Know what the judge ordered.
Rapid therapy with contemporary technology
The Vadodara Consumer Forum reached a similar conclusion in a dispute involving medical insurance. According to Consumer Forum, a person does not need to be admitted to the hospital for 24 hours in order to submit a claim for medical insurance. Modern equipment expedites treatment today, and doctors also discharge patients. The patient doesn’t need to stay in the hospital for any longer than 24 hours in this circumstance.
Ordering money to be made to the patient
The Consumer Forum has directed the Medical Insurance Company to reimburse the patient. Actually, in 2017, a Vadodara resident named Rameshchandra Joshi complained to the Consumer Forum about the National Insurance Company. Joshi claimed that in 2016, his wife struggled with dermatomyositis. He was treated at Ahmedabad’s Lifecare Institute of Medical Science and Research Center at this time.
No Medical Insurance claim was made. referencing Section 3.15
Following treatment, doctors immediately released Joshi’s wife from the hospital. Joshi sought that the insurance provider pays him Rs 44468. Yet Joshi’s claim was rejected by the insurance provider. Invoking clause 3.15, the insurance company refused to pay. Joshi had complained about it to the customer forum. The patient was not admitted for 24 straight hours, the insurance company said, thus the claim was not resolved.
Joshi presented the consumer forum with all of his documents
and made a request for the money. According to Joshi, his wife was admitted on November 24, 2016, at 5:38 p.m. He was released at 6.30 p.m. on November 25, 2016, the next day. In its ruling, the forum stated that it should be considered the patient was admitted to the hospital for a shorter period of time than 24 hours. He is still qualified to file a medical insurance claim. Modern medicine has produced new techniques and medications, so doctors can now treat patients as necessary.
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