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Chirag Bhatt
August 22, 2017
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Dear Support, I have my company group mediclaim policy and required to know IRDA rules on following points : 1. My wife was admitted on 30 July 2017 for Maternity case and 30 July 2017 was last day of my current policy. 2. I have renewed my same policy on same day and it is effective from 31 July 2017 and their is no break in policy. 3. In Old Policy as on 30 July 2017, Maternity Amount capping was Rs. 25000 and No New Born Baby is covered in that policy buy in new policy which is effective from 31 July 2017, capping limit is increase upto Rs. 50000 and new born baby are covered in this renewal. 4. Now My wife was admitted in Hospital from 30 July 2017 To 03 August 2017 and total expenses during this hospitalization is Rs. 38500. 5. Now my query is can i claim the exceeded amount Rs. 13500 from my new renewal policy sum insured limit due to Rs. 25000 limit was available in my pre policy i.e. was till on 30 July 2017. Because of discharge period from the hospital is in new policy and all Rs. 13500 was bill in nee renewal policy period. You are requested to kindly check the above status and update the claim settlement process on above situations as per IRDA Norms..

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Deepak Yohannan
MIC Staff

September 14, 2017 : Answered in 22 Days

Hi Chirag, the claim will only be paid under the policy which is in force on the date of admission and subject to terms and conditions of the policy further subject to limit of balance available in the policy.

The claim will be paid even if it expires before the date of discharge.

There are no IRDA norms and always the claim settlement is subject to policy terms and conditions.

New Born Baby can be covered under the renewed policy..

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