Apni Law Staff asked 12 months ago
My family and I have medical insurance from Mediassist, provided by my employer Hewlett Packard Enterprise in Bangalore. We have a son (8) and a daughter (2), and my wife is expecting our third child. I’ve used maternity benefits only once before, for my daughter, and the policy clearly states a maximum of two claims per employee. Despite this, Mediassist is refusing to cover my wife’s upcoming maternity costs, saying it’s my third child. I’ve paid all premiums and have a top-up policy with an 8 lakh limit. What options do I have to challenge this decision from Mediassist?
Best Answer
Apni Law Staff answered 12 months ago
Under Indian law, health insurance policies are governed by the Insurance Regulatory and Development Authority of India (IRDAI) regulations. You can challenge Mediassist’s decision by appealing their decision citing the policy’s wording, your premium payments, and the fact that the limit is per employee, not per child. You can also approach IRDAI or a consumer forum if your appeal fails.
Please login or Register to submit your answer
