Corona Kavach claim reupdiation citing onset during the 15 days waiting period
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.
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.
Agree with comments of Anuj .
Claim will be repudiated as disease happened within 15 days .
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.