This is a discussion on Can Insurance Co. appeal against OMBUDSMAN judgement? within the Product And Services forums, part of the Miscellaneous category; Dear Sir, I had taken mediclaim policy from National Insurance, karol Bagh New Delhi. I was hospitalised for Gall bladder ...
Dear Sir,
I had taken mediclaim policy from National Insurance, karol Bagh New Delhi.
I was hospitalised for Gall bladder removal surgery twice (first for laprotomy and secondly for open surgery ) as there were certain complication after ist surgery.
I submitted my claim to Insurance company. My claim was repudiated on the ground that the treatment was not taken in the listed hospitals.
I applied to OMBUDSMAN. During hearing, the Insurance company lawyer gave in writing that the company has repudiated the claim on the above mentioned ground and on the ground that I informed the TPA after 15 days ELSE THE Claim is payable.
The OMBUDSMAN rejected the Insurance co plea that it was informed late as it was a case of reimbursement. The ground of repudiation was also rejected and accordingly it awarded the judgement in my favour.
I have received the judgement copy also
I would like to have your kind advise as to whether the Insurance Company can appeal against the judgement and if yes, in which forum and how should I fight this case further.
Your advise is awaited.
Thanking you
Meenakshi