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Rakesh

Rakesh Kaul  | Answer  |Ask -

Answered on Jan 18, 2022

Karuna Question by Karuna on Jan 18, 2022Hindi
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My Health insurance policy waiting period 36 months. I declared pre-existing disease BP and Sugar. Now doctor suggested Aortic Valve replacement for heart which involves substantial amount. If I go for it whether my claim will be considered for settlement or it will be rejected because I have pre-existing BP and Sugar. Please advise me.

Ans:  Coverage pertaining to Aortic Valve Replacement for the Heart will depend on the nature and duration of the illness. Your insurance company will ideally seek clarification on the cause and duration of the illness. Basis the medical documents you submit at the time of claim, if it is observed that your medical condition is not a pre-existing one, nor an effect of Hypertension, then your claim should be considered.

DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Users are advised to pursue the information provided by the rediffGURU only as a source of information to be as a point of reference and to rely on their own judgement when making a decision.
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Sanjib

Sanjib Jha  | Answer  |Ask -

Insurance Expert - Answered on Jun 21, 2022

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Dear Sir, Greetings of the day. I have got a health insurance of family floater type from Tata AIG for a sum of four lakhs. Recently, I got hospitalised and full four lakhs was paid by Tata Aig. But my hospital bill was six lakhs and sixty two thousand. So there was a shortfall of two lakhs sixty-two thousands. I have an Aditya Birla health Policy of family floater type for 45 lakhs. But it will come in to effect after 5 lakhs expenditure. So I myself paid one lakh from my pocket. And for rest one lakh sixty two thousand only I applied for cashless to Aditya Birla .But they denied it. Finally I paid that amount myself and came home. Afterwards I kept continuous follow up with them. Reconsideration and reminder letter was sent by TPA and Treating doctor. But again it was rejected. Now Aditya Birla employee is saying apply for reimbursement. When Tata Aig is clearing full amount, how come Aditya Birla is denying it? And how can I bridge the gap one lakh between two policies? Tata Aig says you have taken full claim so we cannot make your limit from four to five lakhs this year. Pls advise suitably. Best Wishes
Ans: Hi Mr. Tripathi, greetings to you. To answer your first question as to why Aditya Birla won’t provide you with cashless claim as opposed to TATA AIG is because the policy you bought from Aditya Birla is a ‘Super top up plan’ which basically means it is an addition to your base policy which in your case is your TATA AIG policy.

Super top up policies do not offer cashless claims but only provide reimbursements.

The one lakh gap, unfortunately, cannot be filled at this point. However, while renewing your policy you can opt for increased sum insured with TATA AIG. The insurer will ask you a set of questions and schedule medicals to analyse your risk profile. Post that based on your reports, the insurer will take a decision on increasing the limit.   

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Maxim

Maxim Emmanuel  |169 Answers  |Ask -

Soft Skills Trainer - Answered on Apr 25, 2024

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Sir, .I have worked for 5.5 years in my last company but my HR says that I will receive gratuity for 5 years. For those who have worked for 4.5 years, they give it for 5 years but in cases like mine, they reduce it. Also, they have deducted 30 days of my EL w/o giving any logical reasoning saying they do it for all. Pls guide what should I do.
Ans: I have give you a brief explanation about how gratuity is calculated.
Sure this will assist you in understanding the methodologies.

The amount of gratuity for employees whose employer is covered under the Gratuity Act can be calculated using the formula:
Gratuity = n*b*15 / 26

Where n = Tenure of service completed in the company
b = Last drawn basic salary + dearness allowance

For example, you have worked with the XYZ company for a period of 15 years. Your last drawn basic salary along with dearness allowance was Rs 30,000. Hence:

The amount of gratuity = 15 * 30,000 * 15 / 26 = Rs 2,59,615

Two points must be noted here:

As per the Gratuity Act, the amount of gratuity cannot be more than Rs 20 lakh. Any excesses would be treated as ex-gratia.

If the number of years you have worked in the last year of employment is more than six months, then it will be rounded to the nearest figure. Suppose your tenure of service is 16 years 7 months, then you receive the gratuity for 17 years. Otherwise, its for 16 years if it happens to be 16 years 4 months.
In your case 5 years 5 months hence 5 year's as you are below the half yearly for upper round up.


For employees whose employer is not covered under the Gratuity Act, the gratuity amount would be calculated as per the half-month salary on each completed year of service.
The formula is: (15 * Your last drawn salary * the working tenure) / 30.

For example, you have a basic salary of Rs 30,000. You have rendered continuous service of 7 years and the employer is not covered under the Gratuity Act.

Gratuity Amount = (15 * 30,000 * 7) / 30 = Rs 1,05,000.

In regard to your leave,please get a clarification from your HR, as to why they have deducted 30 days of earned leave.
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Kanchan

Kanchan Rai  |168 Answers  |Ask -

Relationships Expert, Mind Coach - Answered on Apr 24, 2024

Asked by Anonymous - Apr 23, 2024Hindi
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My son is 13, diagnosed with anxiety spectrum at age 8.His medications have reduced , takes fluvoximine 50 at night, but has social media addiction,what should i do?
Ans: Managing a child's social media addiction, especially when they have underlying mental health concerns like anxiety, can be challenging but crucial for their well-being. Start by having an open and non-judgmental conversation with your son about his social media use. Express your concerns about how excessive screen time can impact his mental health and overall well-being.Establish clear rules and boundaries around screen time and social media use. This could include limiting the amount of time he spends on social media each day or setting specific times when he's allowed to use it.
Lead by Example: Model healthy screen time habits yourself. Show your son that you prioritize face-to-face interactions, hobbies, and other activities over excessive screen time.Encourage your son to engage in offline activities that he enjoys and that promote social interaction, physical activity, and creativity. This could include sports, hobbies, art, or spending time with friends and family.Keep an eye on your son's social media use and monitor the content he's consuming. Consider using parental control apps or settings to limit access to certain apps or websites.If your son's social media addiction is significantly impacting his mental health or daily functioning, consider seeking support from a therapist or counselor who specializes in treating addiction and/or anxiety. They can provide individualized strategies and support for managing his social media use in a healthy way.
Encourage Healthy Coping Strategies: Help your son develop healthy coping strategies for managing his anxiety, such as mindfulness, deep breathing exercises, or engaging in calming activities when he feels overwhelmed.
By taking proactive steps to address your son's social media addiction and providing support for his anxiety, you can help him develop healthier habits and improve his overall well-being. Remember to approach the situation with empathy, patience, and understanding, and seek professional support if needed.
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Kanchan

Kanchan Rai  |168 Answers  |Ask -

Relationships Expert, Mind Coach - Answered on Apr 24, 2024

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Hi ! I am a 38 year old divorced woman. Its almost 10 years that I got divorced, from a man with whom I was married for 2 months. Since then, I never had a long relationship with anyone. For the past 1 month, I feel I have developed feelings for my cousin (sister) who is 10 years older to me. She too is divorced, long back. (2006). I understand she too has feelings for me. What should I do. Please suggest.
Ans: Navigating feelings for a family member can be complex, especially when considering societal norms and potential family dynamics. It's understandable to feel uncertain about how to proceed in such a situation.

First and foremost, it's important to consider the potential implications and consequences of pursuing a romantic relationship with your cousin. While relationships between cousins are not legally prohibited in many places, they can sometimes face social stigma or disapproval from family members.

Before taking any further steps, it's crucial to have open and honest communication with your cousin about your feelings and concerns. Discussing your mutual feelings in a respectful and sensitive manner can help both of you understand each other's perspectives and make informed decisions about how to move forward.

Additionally, it may be beneficial to seek guidance from a therapist or counselor who can provide support and help you navigate your feelings and the potential impact on your family dynamic. They can also offer strategies for communicating effectively and managing any challenges that may arise.

Ultimately, the decision of whether to pursue a romantic relationship with your cousin is a deeply personal one that only you and your cousin can make. It's essential to prioritize open communication, mutual respect, and consideration for the feelings and well-being of everyone involved.

Regardless of the outcome, remember that you deserve to pursue happiness and fulfillment in your relationships, and seeking support from trusted friends, family members, or professionals can help you navigate this situation with clarity and confidence.
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Kanchan

Kanchan Rai  |168 Answers  |Ask -

Relationships Expert, Mind Coach - Answered on Apr 24, 2024

Asked by Anonymous - Apr 16, 2024Hindi
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I got married three months ago, during courtship period my ex was in my office but then my marriage wasn't fixed properly ,when it got yeses from both the side I changed my office,but I couldn't tell this to my husband and also I lied about my virginity,he was also not virgin and after marriage I confessed all this ,now he is not forgiving me for my dishonesty and not letting me come home also he abuse me verbally ,slapped me..I also feel like cheated for not letting me know this side of him before marriage..How should I go ahead?
Ans: I'm truly sorry to hear about the difficulties you're facing in your new marriage. It's concerning to hear that you're experiencing verbal abuse and physical violence from your husband. No one deserves to be treated this way, and it's important to prioritize your safety and well-being.

First and foremost, if you are in immediate danger or feel unsafe, please reach out to local authorities or a trusted friend or family member for support. Your safety is paramount.

In terms of next steps, it's essential to seek support and assistance from professionals who can help you navigate this situation. Consider reaching out to a therapist or counselor who specializes in relationships and domestic violence. They can provide you with guidance, support, and resources to help you make informed decisions about your next steps.

Additionally, you may want to consider reaching out to organizations or hotlines that specialize in supporting individuals experiencing domestic violence. They can offer confidential support, safety planning, and resources to help you leave the abusive situation and rebuild your life.

It's also crucial to recognize that you are not responsible for your husband's abusive behavior, and you deserve to be treated with dignity and respect in your marriage. If your husband is unwilling to seek help or change his behavior, it may be necessary to consider your options for leaving the relationship to ensure your safety and well-being.

Leaving an abusive relationship can be challenging, but you don't have to face it alone. There are people and resources available to support you every step of the way. Please prioritize your safety and take steps to protect yourself from further harm. You deserve to live a life free from abuse and violence.
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Kanchan

Kanchan Rai  |168 Answers  |Ask -

Relationships Expert, Mind Coach - Answered on Apr 24, 2024

Asked by Anonymous - Apr 13, 2024Hindi
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Relationship
I am single mother of 12 year old boy and got divorced last year after 7 years of living seperate from my ex husband, I got married in 2010 through matrimonial site and had very toxic and abusive relationship, so I came to my maternal home in 2016 completely. There were many occasions when he approached me and promised to behave properly but failed to do so . He only filed for divorce by making false accusations of being characterless. I gave him divorce and in return I got very less alimony or the amount which was given in cash to them in my marriage. Now I came to know that he remarried and living his life . He is still in contact with my son and sometimes he blame me and my parents for this divorce. My first question is that is he trying to manipulate my son ( he is not bearing any education expenses of my son) And when I ask my son if I can also move on in my life, he refuses and says I don't want to share you with anyone. So I am very confused.
Ans: I'm sorry to hear about the challenges you've been facing. It sounds like you've been through a lot and are trying to navigate a difficult situation for both yourself and your son.

Regarding your ex-husband's behavior, it's possible that he may be trying to manipulate your son, especially if he is blaming you and your parents for the divorce. Children can be susceptible to manipulation, especially when they're caught in the middle of a divorce. It's important to maintain open communication with your son and reassure him that the divorce was not his fault and that both you and your ex-husband still love him.

As for your son's reluctance to see you move on, it's not uncommon for children of divorce to struggle with the idea of one or both parents moving on and forming new relationships. Your son may fear losing the close relationship he has with you or worry about how a new relationship might change his life. It's essential to validate his feelings and reassure him that your love for him will not change, regardless of any new relationships you may have.

It might also be helpful to involve a therapist or counselor who can work with both you and your son to navigate these emotions and provide support during this challenging time. Additionally, continuing to foster a strong, positive relationship with your son and maintaining open communication will be crucial as you both move forward.

Ultimately, while it's important to consider your son's feelings, it's also essential for you to take care of yourself and pursue your own happiness. Balancing your needs with those of your son can be challenging, but with time, patience, and support, you can find a way forward that works for both of you.
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DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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