Covered, Yet Battered

When Noida resident Rakesh Jaiswal had to be admitted to a private hospital for a sudden heart issue, he was under the impression that his cashless medical insurance policy would take care of the finances. But, it didn’t work the way he thought. The third-party administrator denied the cashless facility to him and he had to cough up the entire bill himself. Once out of the hospital, Jaiswal contested the rejection of his claim with the insurer only to be informed that he was not eligible for the facility. Undeterred, he moved the mandated government forum for grievance redressal, and was awarded a compensation fee later. A large number of insurance claims – life, health or motor – get rejected by insurance companies every year. While in some cases, there are negligence on the part of the insurers, most cases are dropped because of false information, incorrect medical...