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Corona Kavach claim reupdiation citing onset during the 15 days waiting period

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17 May, 2021 by  Avinash Sonee

One of my customers has taken a Corona Kavach policy (from Star Health) which was valid from 24/07/2020 to 05/05/2021 for 5 lakhs.


On 09/08/2020, he's got admitted in a hospital at Hyderabad with complaints of SOB, cough, fever, etc. since 4 days. He's first consulted a doctor in his town for cough and fever. The actual Covid-19 positive report is of 10/08/2020.


The company has rejected the hospitalization claim citing that

'It is observed from the consultation report dated 04/08/2020 and investigation report dated 04/08/2020, the onset of the above disease is during the first 15 days from the date of commencement of the policy.'


Can this repudiation be contested? Please advise.

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COVID19

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18 May, 2021

Hey Avinash,


It is a valid repudiation. Kavach has a mandatory 15 days waiting period, so any symptoms that start during this period or any admission for Covid that happens during this period, is not claimable.


Anuj

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18 May, 2021

Dear Avinash

Agree with comments of Anuj .

Claim will be repudiated as disease happened within 15 days .

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18 May, 2021
Avinash Sonee

Thank you for confirmation.

Customer still wants to contest the claim saying that the fever since 3-4 days may not have been covid.

I've asked him to approach legally if wants to contest after approaching the grievance cell and the ombusdman.


Thank you


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20 May, 2021
Avinash Sonee
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20 May, 2021
Avinash Sonee
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20 Jun, 2021
Avinash Sonee
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