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Health Insurance - Ombudsman

The term "Ombudsman" comes from Swedish word "Omboodz-man" meaning "a grievance man or person", which the Oxford Dictionary refers to as the " people's defender".In most democratic countries, there are Ombudsman institutions that are responsible organizations that make the government...Read More

Posted on : Friday, May 28, 2010 12:00 AM
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sir,further to GAJANAN's comments. It is true in spirit. But,the practical experience is the Ombudsman personnaly calls the Insurere/TPA officer. The opposite insured/ claimant has to put in his argument. That is the imbalance that has been brought forward. GAJANAN is right in saying that it is on submitted written documents, the ombudsman has to given decision.But, the scenerio is different. It would not be a big deal if the less informed Insured gets the help to put his correct submission in contrast to callous mechanical attitude adopted by TPA/Insurers in the first instance.
Replied on Wednesday, March 24, 2010 12:00 AM

drkapil
(Guest)
I have a query, my insurance agent had done some forgery, he had done shifting between available funds with out my knowledge, and so there is loss of more than 1200 units in my policy. can any body tell me how can i bring him down?
Replied on Saturday, August 7, 2010 12:00 AM
is there any mechanism to lodge a grievance complaint to LIC ombudsman,kochi through Online service
Replied on Thursday, September 9, 2010 12:00 AM
I HAD FILED AN HEALTH CHECK UP CLAIM WITH RAKSHATPA FARIDABAD ON 9-06-2010.AND SUBSEQUENTLY I HAD CONFIRMED THAT THE SAME WAS RECD IN THERE OFFICE ON 10-06-2010.I AM INSURED WITH NEW INDIA ASSURANCE COMPANY ROHTAK.NOW THE TPA IS NEITHER REPLYING NOR PAYING MY CLAIM .WHAT ARE THE OPTIONS AVAILABLE TO ME .IF I TAKE CLAIM TO OMBUDSMAN WHICH IS IN CHANDIGARH.I SHALL HAVE TO WASTE ONE DAY TO ATTEND HEARING AND SHALL HAVE MONETARY LOSS ALSO .IS THE TPA GOING TO REIMBURSE THE EXPENSES I SHALL DO FOR GOING TO CHANDIGARH IF THE CASE IS DECIDED IN MY FAVOUR. IS THERE ANY PRECEDENCE AND THE TPA BEING PENALISED FOR HARRASING THE INSURED PLEASE ENLIGHTEN ME ON THIS.
Replied on Friday, October 29, 2010 10:28 PM
my mother is insured by icici prudencial life insurance but it is not paying my claim. icici pru life is very bad company. it is not paying any one claim if any misshappening. i have lot of people who is suffering such tipe of problem by ICICI pru life.
i am suffering since last 2 year. how can i get my claim?
Replied on Wednesday, August 10, 2011 11:28 AM
 




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