is it legal?

I am holding icici prudential hospial care policy it have waiting period of 3 months.During waiting period of three months i come to face with sign/evideness of illness.i undergone major surgeory after 4 months.after discharge from hospital isend all bills.But they rjected my claims that sign /evidence ha[ppen within waiting period.They also inform that it is claerly mention in policy document.when i filled pllication form nothing is mention about iwaiting perid and at that time ihave no illness and agent not mention anything.I claimed only for surgeory which conducted after wiating period .Any chance for me?

I suggest you to consult an IRDA, who must be your friend. Or else take some professional advice.

Good Luck

Since you say, within three months, you had symptoms and sought medical advice, surgery after four months has no relevance. You have to see if Document contains this limitation clause, which it most probably will and agent simply overlooked in his anxiety to enroll you. If you had indicated medical history then either they would have rejected or hiked the premium. The right course of action would have been to get medical examination done and recorded while taking insurance, this is what most agents don't inform the customers.To save few rupees and some hassles customers agree.

Now, if you have seen doctor after three months and you had no previous medical history then you can file complain before Insurance Ombudsman or with IRDA. Alternatively you can approach civil court for settlement of claims and seek a good lawyer who is a very good friend of yours.Another way is to file complain before consumer forum depending on your claim.This is most easy option and you might get justice faster.

Things to do before you approach

IRDA website( go to Grievance Cell)
http://www.irdaindia.org/

Ombudsman ( Check your area)

http://www.irdaindia.org/ombudsmenlist_nov07.htm

How consumer court can help you

http://www.expressindia.com/latest-...ay-customer-for-insufficient-services/319822/




pk

I do not think that any of Govt. websites are of any use, as my experience had time and again proved it. The best option is Consumer courts are legal help.