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Health Insurance Claim Rejected for Non-Disclosure: What Should the Policyholder Check First?

A health insurance claim may be rejected when the insurer alleges that the policyholder failed to disclose an earlier illness, treatment, consultation, investigation, surgery, medication or other material medical information while purchasing the policy. A rejection for “non-disclosure” can have wider consequences than the rejection of one hospital bill. In [...]

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Defective House Construction: Cracks, Leakage and Poor Workmanship—What Evidence Is Important?

Defective house construction can cause serious loss to a homeowner. Cracks may appear in walls, leakage may continue during rain, tiles may loosen, plaster may peel, electrical work may remain unsafe, plumbing may fail, or finishing work may be visibly poor. The contractor may say these are minor issues, natural [...]

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Insurance Company Paid Only Part of the Claim: Can the Policyholder Dispute the Deduction?

An insurance claim may not always be rejected fully. In many cases, the insurance company may approve the claim only partly and deduct a substantial amount. The policyholder may receive a settlement message showing a reduced amount, but the reason for deduction may not be clear. Partial settlement can arise [...]

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Medical Negligence or Known Complication? How Should a Patient Assess What Happened?

A patient may undergo surgery, ICU treatment, delivery, diagnostic procedure or other hospital treatment expecting recovery. But sometimes the result may be unexpected: infection, bleeding, organ injury, nerve injury, vision loss, worsening condition, repeat surgery, disability or death. In such situations, families often ask whether it is medical negligence or [...]

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Contractor Took Advance but Did Not Complete the Work: Evidence Consumers Should Preserve

Many house owners pay advance amounts to contractors for construction, renovation, roofing, waterproofing, interior work, painting, plumbing, electrical work or finishing work. The contractor may promise quick completion, collect money for materials and labour, start some work and later delay, stop attending calls, abandon the site or demand additional amounts. [...]

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Cashless Health Insurance Denied: Does It Mean the Final Insurance Claim Is Rejected?

Cashless health insurance denial creates immediate pressure during hospitalisation. The hospital may ask the patient or family to pay the bill before discharge. The TPA or insurer may say that cashless approval is not possible due to query, incomplete documents, suspected pre-existing disease, waiting period, policy exclusion, non-disclosure allegation or [...]

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Wrong CIBIL Entry After Loan Closure: How Should a Consumer Proceed?

A wrong CIBIL entry after loan closure can seriously affect a consumer’s financial life. A person may have fully repaid a personal loan, vehicle loan, credit card outstanding, gold loan, housing loan or consumer durable loan, but the credit report may still show outstanding balance, overdue amount, settled status, written-off [...]

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