Did you know Insurance Fraud is akin to an industry in the West. Special classes are held to make people proficient in perpetrating an insurance fraud. There are organized gangs that specialize in staging vehicular accidents, arson and sabotage of property - all to one end - getting a fat claim.
Insurance fraud is a globally accepted white collared crime, more so in India where till recently defrauding an insurance company meant cheating the Government and, by and large, people took as their right.
What is insurance fraud?
Insurance fraud is any deliberate attempt against or by an insurance company, insurance agent or the consumer for the purpose of unwarranted financial gain. Fraud can occur during the process of buying, using, selling, underwriting insurance or while staking a claim.
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Economic Times - Monday 8th March carried a warning for those opting for Critical Illness rider (one of the riders offered with basic Life Insurance policy) - 'Read the fine print and confirm which critical illnesses you are covered for and what are the conditions to qualify?"
The advent of Mobile telephony introduced a very important word in our daily vocabulary - CONDITIONS APPLY - You maybe promised the sky; You may think you are in for the best deal but promises can be easily circumvented because CONDITIONS APPLY!!
Planned non disclosure by clients has always been a major problem faced by Insurance industry. Clause(s) mentioned in fine print, qualifying requirements is a subtle form of non-disclosure by the Insurance industry and it is time both the consumers and the industry have to come clean.
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Rajesh S, 38 (name changed), vice president of an advertising company, purchased life insurance in 2001, 3 policies collectively worth Rs 5.4 million. July 2003, Rajesh suffered from a Lt sided stroke, resulting in loss of speech and Rt sided paralysis. Today 6 months later his speech has not yet returned and he still can not effectively use his right hand, though he can walk on his own, dragging the right lower limb. Rajesh’s career is almost over.
At 40, he has nearly 25+ years to live and no known source of income.
While taking life insurance, Rajesh was offered the Critical Illness Rider, but had not opted for it.
Even Waiver of Premium Rider would have been of immense help but apparently no one thought he would need it.
Continue reading "Life Insurance Riders!" »
The ongoing tussle raging between hospitals and nursing homes on one side and TPAs on the other, against cash less healthcare model may soon be over but the embarrassing queries posed by TPAs/ insurance companies seeking to justify the treatment is much more difficult to digest. Not only is the corporate sector but of late, even the community at large is demanding accountability and ethics in healthcare.
Why is it so?
Continue reading "Accountability in Doctors" »
