Covid times have taught us lessons the harsh way. Be it the Covid appropriate behavior, or your personal investment choices so as to keep your family safe and running, in case the disaster strikes.
In some cases the person lived to correct the wrong , but certain people were not lucky enough to return from the hospital bed and reassess the investments they had done.
Same applies for Insurance policies – term life, Health, Medical, Insurance against Home loans in case the subscriber dies etc., there is an endless list of providers fleecing the customers with lucrative looking , GOLD plated policies.
Once a person dies, and his family reaches out to Insurance company for redressal, then only one comes to know the terms and conditions that were agreed on the policy and in most of the cases if not all, the claim is rejected owing to some reason or the other - written with * asterisk and in small letters at the bottom of the policy.
Surprisingly, most of the reasons for claim rejection are flimsy such as the person did not die in a hospital, cause of death is not covered as a critical disease in the agreed terms and conditions of the policy and many more such reasons.
One such intimation received very recently from HDFC ERGO who died due to Covid says the following-
“With reference to the Critical Illness Claim No RR-CI21-12460458 , we have scrutinized the same with respect to policy terms & conditions. We regret to inform you that Your claim has been declined due to below mentioned reason.: As per the submitted documents, insured died due to cardiopulmonary arrest, acute respiratory distress syndrome, multiple organ dysfunction syndrome, covid 19. As the said ailments are not covered under Critical Illness enlisted in SECTION 3. MAJOR MEDICAL ILLNESS & PROCEDURES of policy terms and conditions, hence this claim is being repudiated in the light of above. The illness covered under Critical Illness and Procedures are: : (1) Cancer (2) End Stage Renal Failure (3) Multiple Sclerosis (4) Major Organ Transplant (5) Heart Valve Replacement (6) Coronary Artery Bypass Graft (7) Stroke ( Paralysis (9) Myocardial Infarction”.
Some one got to ask them how the hell one would know in 2016, time when policy was taken that there would be a pandemic COVID-19 and millions will die due to this.None must have heard the name of this disease then.
Or , did the insurance company ever cared to let the subscribers know in 2020 when the pandemic spread to get their policies upgraded to cover this illness.
There is a need to use all possible means to raise concerns so that the Voices of those facing the consequences of this irrationale policies be heard.
The Judiciary must take up this issue suo moto so that the families who have lost near and dear ones, Lost the only earning member in the family and struggling to save their household, pay back the home loans , pay the education expenses of their Children are taken care off.