Dear Sir, I had taken a travel insurance policy & while we were visiting dubai, i had to spend money on medical expenses. As it was a urgency medical treatment took place in hotel only as there were no hospitals nearby. However, now travel insurance is rejecting the claim on the basis of no hospitalisation. Is there any possibility of claim settlement?
The police terms and conditions are to be seen to advise you properly.
If the travel insurance policy covers the instant medical expenses also then you will be eligible for the same, however if there is no mention that hospitalization is essential to claim then you can very well drag the service provider to consumer forum to claim compensation as well as the expenses incurred.
Terms of policy must be containing clause that claim would be paid only if you are hospitalised
if you are not hospitalised you would not be paid claim amount
Would you please elaborate as to what the emergency medical treatment was in the hotel to give you a clear advice? Also, The terms and conditions of the travel insurance are to be scrutinised.
In my opinion, chances of getting repudiation of medical claim reversed are very less as Hospitalisation forms a basic crux to Claim medical insurance in most of the policies Offered by Indian insurers.
Check the Insurance agreement clause what they have mentioned in it 24 or 48 hours hospitalization is compulsory or not. Then only you will able to claim the settlement.
Dear Client,
In the Present Scenario, you had taken a travel insurance policy, and when visiting Dubai, you had to spend money for medical expenses. As the treatment was urgent and there were no hospitals nearby, it took place in the hotel. However, now, the travel insurance has been rejected on the basis of no hospitalisation, and hence you want to enquire on the possibility of claiming a settlement for the same. Herein, firstly, it is suggested that you review the terms of the insurance policy taken, that provides clauses on medical treatment, and if the same specifies the place of medical treatment in order to cover such expenses. Secondly, all the documents that pertain to the medical expenses incurred must be gathered to show evidences. Besides, you may also argue on grounds of necessity, and unavailability of hospitals, with relevant evidences, for taking treatment at the hotel. You may also approach the consumer forum to claim compensation and the unfair denial of the insurance company.
Hope you find this answer beneficial for resolving the dispute.
Show policy and conditions.
It all depends on the terms of the travel insurance policy. Does it cover treatment outside a hospital in case of emergency? Did you inform the insurance company of your intended treatment in a hotel on emergency basis, and if so, what was their response? Normally, such treatments are outside the scope of the policy.
- You should read the policy terms and condition , as this condition of hospitalization is mentioned therein or not .
- If this condition is not mentioned in the insurance policy clearly then you have right to claim the said expenses.
- You can send a legal notice to the said company before filing a complaint before the consumer forum.
You have to confirm from the policy and read it, to see if medical expenses are to be reimbursed without hospitalization
In case yes, sue them!
