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Ramalingam

Ramalingam Kalirajan  |7497 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on May 02, 2024

Ramalingam Kalirajan has over 23 years of experience in mutual funds and financial planning.
He has an MBA in finance from the University of Madras and is a certified financial planner.
He is the director and chief financial planner at Holistic Investment, a Chennai-based firm that offers financial planning and wealth management advice.... more
Shsilasri Question by Shsilasri on Apr 05, 2024Hindi
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Hello sir ,my huband has taken medical insurance frm manipal cigna frm 2015 till date never claimed anything all these years but last year july suddenly my husband got pneumonia he got hospitalized before joining inthe hospital we consulted the insurance agent and took necessary file number to claim insurance but sadly at the end insurance company rejected to pay bill saying(2.5lks) he used to pay 58 thosand per year family floater,now thy have canceled whole policy and thy didn't even paying the amt we paid all these years ,agent is not responding can we do anything to get our hard-earned money back now we dont have any medical insurance he is 57yrs now pls suggest anything we can do

Ans: I'm truly sorry to hear about your husband's health complications and the subsequent challenges with your medical insurance. Facing such situations can be distressing, especially when dealing with unexpected denials and cancellations. It's important to take action to address this issue.

Firstly, gather all relevant documents, including policy details, correspondence with the insurance company, and any communication with the agent. This documentation will be crucial in understanding the reasons for the denial and in any potential appeals or legal actions.

Next, consider reaching out directly to the insurance company to request a review of the decision and clarification on why the claim was rejected. If you're unsatisfied with their response, you may escalate the matter through their grievance redressal mechanism or regulatory authorities.

Additionally, seeking legal advice from a lawyer who specializes in insurance matters could provide insight into your rights and options for recourse. They can help you navigate the complex legal landscape and pursue appropriate action to recover your hard-earned money.

While the situation is undoubtedly challenging, remember that you're not alone. Reach out to consumer rights organizations or advocacy groups that may offer support and guidance in dealing with insurance-related issues. Your perseverance and determination to seek justice are commendable, and I hope you find a resolution that provides the relief and security you deserve.
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

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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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Sanjib

Sanjib Jha  | Answer  |Ask -

Insurance Expert - Answered on Nov 24, 2022

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I was customer of Oriental Bank of Commerce. Being a customer of Oriental Bank of Commerce, Oriental Insurance Company provided Group Health Insurance Policy and inception date was 04-05-2015. My policy with them continued till 03-05-2021 without any break. Because Oriental Bank of Commerce merged with Punjab National Bank, Oriental Insurance Company discontinued that policy from 03-05-2021 onward. Being a customer of Punjab National Bank, I approached them, and they migrated my Group Health Insurance Policy of Oriental Insurance Company to Star Group Health Insurance Policy for customers of Punjab National Bank from 04-05-2021 to 03-05-2022.  As All my policy periods were continued from 04-05-2015 till 03-05-2021 with Oriental Insurance Company, Star Health Insurance given me the benefit of pre-existing disease waiting periods being waived because of continuity (They mentioned it in Policy Document too). They reimbursed my 1st claim of 15 July to 22 July 2021 (Non Empaneled Hospital) and Cashless claim of 16 December to 19/12/2021 but denied reimbursement of 19/12/2021 to 26/12/2021 with the excuse of pre-existing disease even I directly shifted from cashless hospital to non-Empaneled Hospital for same problem because Empaneled hospital having been less facilities.  Here I want to address that I was discharged from Cashless Hospital, on request, to get treated in Higher Hospital and treatment was in continuation of previous cashless hospital to new hospital. So, sir, please guide me accordingly as my correspondence with them is not fruitful.

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Ramalingam

Ramalingam Kalirajan  |7497 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on May 11, 2024

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I have bought a Health Insurance for My family 2+1 on Aug 23 with a 25Lacs covering from Reliance General Insurance Co. This Policy is port from Niva Bhupa which i had taken in 2021. I come to know some one from my surrounding is that the Reliance is not settling claims Properly and full. This policy is taken for 2year. Can u Suggest me
Ans: I understand you're concerned about Reliance General settling claims properly. It's good to be aware! Here's how we can approach this:

Claim Settlement Ratio (CSR) Check: Every insurance company has a CSR, a public record showing the percentage of claims they settle. You can check Reliance General's CSR online to see their historical performance.

Policy Review: Review your policy documents carefully. Understand the terms and exclusions related to claim settlements. If something seems unclear, reach out to Reliance General for clarification.

Network Hospitals: Using network hospitals within your policy can streamline the claim settlement process.

Remember, a single experience doesn't represent the entire picture. However, your concern is valid. Let's not worry, we can assess further!

You did well porting your policy! Health insurance is crucial, and you've taken a great step for your family.

Moving forward: If you'd like a more in-depth analysis of your health insurance options, consider consulting a Certified Financial Planner (CFP). They can assess your specific needs and recommend the best plan based on your family's requirements.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

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Dear experts, I was reading about V Narayanan’s journey from a Tamil medium school to ISRO chief. I’m an engineering student from a modest background. My father works in a private firm and mother is a housewife. Finances are a major hurdle. Are there specific scholarships or support programmes for students aiming to get into prestigious institutions like Anna University?
Ans: Pursuing higher education at Anna University is a commendable goal, and there are several scholarships and support programs available to assist students from modest backgrounds. Some of these include the Tamil Nadu Government Scholarships, which provide financial assistance to cover tuition fees, the DHAANISH BC/MBC/DNC Scholarship, SC/ST Scholarship, Central Government Scholarships, AICTE Pragati Scholarship for Girls, and Institutional Scholarships at Anna University. The application process involves eligibility verification, documentation, application submission, and tracking deadlines. Additional support includes educational loans at subsidized interest rates for economically weaker sections and fee waivers for meritorious and needy students. It is advisable to regularly check Anna University and the Directorate of Collegiate Education, Tamil Nadu, for the latest updates on available scholarships and application procedures. Also please visit buddy4study website & explore, You will get a lot of inputs about Schoarhsips. All The BEST for Your Prosperous Future.

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Nayagam P

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Help Needed: Unable to Login to JEE Mains Portal Due to Mistaken DOB Entry Hello Everyone, I’m reaching out to seek advice and support from anyone familiar with handling issues on the JEE Mains portal. Despite entering my correct application details, I’ve been unable to log in to download my admit card, and I believe it’s due to a mistake I made during the application process. The Problem During registration, I mistakenly entered the wrong date of birth. My correct date of birth is 12/08/2008, but I accidentally entered 22/08/2008. Now, neither date works when trying to log in, and I keep getting the error message: "Invalid Application No or Date of Birth." My Details: Name: Shivam Srivastav Application Number: ...................... Registered Contact Number: ...................... Registered Email ID: ................. Request for Help If anyone has faced a similar issue or knows how to resolve this problem, please share your suggestions. I’ve already emailed the authorities but am waiting for a response. I’m also prepared to provide necessary documents, such as my Class 10th marksheet, to verify my correct date of birth. Any help or guidance would be highly appreciated! Thank you for your time and support. Warm Regards,
Ans: Satyam, First step: Verify the following right away: Any SMS on your Registered Mobile Number from NTA from the date you registered in the NTA portal; your Registered email Inbox for any mails from NTA from that date. There's more likely you missed it or the mails ended in SPAM/JUNK Folder.

The second step is visiting NTA Jee Main Website. Click Contacts US Menu. around 4-5 Helpline Numbers can be tried and also send REMINDER MAILS to all mail IDS supplied there from your Registered eMail ID, by providing the following information: (a) Your Application Number (2) Your Registered Mobile Number (3) The nature of the problem & (4) Scanned copy of your Class 10 Marksheet for your DOB proof.

Please be advised; admit cards will only be released on January 19 or 20.

Third step: You have not indicated you are from which place? If you know of any colleagues or family friends in Delhi, ask them to personally visit the NTA Office and try to settle the matter this week; by next week, the Admit Card would be issued.

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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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