Lady doctor gets reimbursement for eye surgery from Oriental Insurance

CERS helps a harried lady doctor get reimbursement for eye surgery from Oriental Insurance

Ahmedabad,May 8th , 2013

Consumer Education & Research Society (CERS) once again came to the rescue of a harassed consumer. This time an Ahmedabad-based lady doctor who was denied reimbursement for an eye surgery by her insurance company.

As per the case details, Dr. Diksha Sawant*, a resident of Bopal area of the city, had purchased a health insurance policy from The Oriental Insurance Co. Ltd about 20 years ago and it was renewed every year since then. The policy was valid during the period from 16 March, 2009 to 15 March, 2010. Dr. Sawant* had an eye surgery during this period and when she made a claim for reimbursement of the cost, the insurance company rejected it saying that she had only received injections for macular degeneration, which is not an eye surgery and therefore she was not eligible for reimbursement as per the policy terms.

On refusal from the insurance company, Dr Sawant* approached CERS and after verifying the details, CERS filed a complaint before the Consumer Dispute Redressal Forum, Ahmedabad (Additional). CERS also submitted that the administration of injection to Dr. Sawant* is done under local anaesthesia and is a surgical procedure related to Retina and Vitreous surgery. The procedure has to be carried out in an Operation theater. So, it is definitely a type of ‘EYE SURGERY’. And for ‘Eye Surgery’, hospitalisation of 24 hours or more is not necessary for reimbursement of claim as per the terms and conditions of the insurance policy. After hearing both the parties, the forum did not find any merit in the arguments made by the insurance company and accepting the certificate issued by the doctor, who performed the surgery, it ruled the order in favor of the complainant.

The forum has not only ordered the insurance company to reimburse the cost of eye surgery i.e. Rs. 72,029 but also to pay interest @8% on this amount from 22/1/2010 for denying the reimbursement. It has also ordered the insurer to pay Rs. 5,000 towards compensation for mental agony faced by the doctor and Rs. 3,000 towards the litigation cost.

However, the total claim amount was Rs. 1,44,058/- (cost of 2 injections of Rs. 72,029/- each). But through oversight, the Forum granted claim for only one injection. So, the complainant will have to file an Appeal before the State Commission to claim the full amount i.e. Rs. 1,44,058/-.

*Name changed on request

For further information please contact

Ms Pritee Shah (O) 079-27489945/46

Deemed Conveyance and Other Resources

MAHARASHTRA CHS RTI UNION
We encourage housing societies to approach authorities directly to apply for Deemed Conveyance without engaging any professionals at exorbitant fees.

J.B.Patel (Jeby)
Housing Societies’ Activist!
Mobile:9820538570

12._Contact_Numbers_of_District_Deputy_Registrar_and_Competent_Authority_Deemed_Conveyance.PDF

11._Deemed_Conveyance_-_Form_of_Application__Form_No.7_

10._Deemed_Conveyance_-_Form_of_Application_for_Registration_of_Society__Form_No.6_

9._Deemed_Conveyance_-_GR_-_07.12.2012_-_15.12.2012_to_30.06.2013

8._Deemed_Conveyance_-_GR_on_Documents_Required_-_26.11.2012

7._Deemed_Conveyance_-_No_Notice_to_Owners_in__cases_on_Non-Govt_Lands_Maha_GR_-_23.11.2012 6._Notice_Letter_to_Builder_and_Land_Owner_for_Conveyance_Deed__Deemed_Conveyance_Deed_Execution 5._Essential_Documents_Required_for_Deemed_Conveyance_G.R._Dated_25.02.2011

4._Deemed_Conveyance_Requirements_-_Hemant_Agarwal

1._Solutions_to_Conveyance_Problems.doc

 

MAHARASHTRA CHS RTI Union
For FREE membership, write to < gladiator4mc@gmail.com > , < jebypatel@rediffmail.com >

Visit:
Guidance to victimized members of a CHS:
http://tinyurl.com/4-pt-attack-on-corrupt-mg-cmte
Andheri Panchvati CHS Ltd.case study of harassment – 23.05.2013:
https://docs.google.com/file/d/0B4wUjYmxbjtzWUtuZkxSX1lISDg/edit?pli=1
http://www.facebook.com/jebypatel
http://soundcloud.com/jebypatel/90-8-radio-broadcast-housing
For Co-op Socy. Problems : http://tinyurl.com/Co-opSocyProblems
http://tinyurl.com/4RTIForms
http://tinyurl.com/LandmarkCourtOrders
http://tinyurl.com/ImpGRsCirculars
http://tinyurl.com/BldgPropDepts
http://tinyurl.com/RTILandmarkOrders
Website of DDR III: ddr3csmumbai.org
Website of MHADA http://www.mhada.org/
Website of Commissioner for Cooperation and Registrar,
Cooperative Societies (CC & RCS), Maharashtra State, Pune:
https://sahakarayukta.maharashtra.gov.in/SITE/Home/Home.aspx
Website of CIC: www.sic.Maharashtra.gov.in
http://rti.india.gov.in/sitemap.php
Website of Maharashtra Govt.: www.Maharashtra.gov.in
Website of Bombay High Court: http://bombayhighcourt.nic.in/
Website of Prime Ministers office http://www.pmindia.gov.in/
Website of Deemed Conveyance related GRs and Circulars:
http://housing.maharashtra.gov.in
Website for Legal Advice: http://thepracticeoflawjalan.blogspot.in/2012/04/legal-options.html

TDS on Purchase of Immovable Property (Section 194 IA)

1. Section has been inserted w.e.f. 01.06.2013.

2. Deductor & Deductee: Any person (being a transferee) responsible for paying (other than person referred to in section 194LA) to a Resident transferor any sum by way of consideration for transfer of any immovable property (other agricultural land in rural area in India), is liable to deduct the TDS under this section.

3. Time of deduction: At the time of payment or credit to the transferor in the books of transferee, whichever is earlier.

4. Rate of TDS:-

a. In case of PAN of Deductee is available-1%

b. In case of NO PAN of Deductee is available-20%

5. Limit: No TDS is to be deducted when consideration is less than Rs 50, 00,000.

6. Provision of TAN not applicable.

7. Immovable property means any land or building or part of building. Such may be situated in India or may be situated out of India.

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Click Here to read further views / opinions also

Some more comments are available here

Refusing to file FIR may land Cop in Jail for a Year

Refusing to register an FIR on jurisdictional ground could now cost a policeman a year in jail. Taking strong view of increasing instances of such acts by police in various states, the Union home ministry has issued strict instructions to all states to not only initiate departmental enquiry against such cops but also prosecute them under Indian Penal Code (IPC).
The home ministry told the states and Union Territories to clearly instruct all police stations that failure to register FIR on receipt of information about any cognisable offence will invite prosecution of the duty police officer under IPC Section 166A (government official disobeying law) which will invite imprisonment up to one year.
In its latest directive, the MHA told the states and UTs that policemen should be sensitized to respond to complaints with alacrity, whether it is from man or woman, and must apprehend the accused immediately after the complaint, as it adversely impacts the victim and there is tendency of persons committing crimes to slip away when there is delay on extraneous grounds like jurisdiction.
Further, if after registration of FIR, upon investigation, it is found that the subject matter relates to jurisdiction of some other police station, the FIR may be appropriately transferred to the police station under which the case falls. 
 
The home ministry said there should be clear instruction by the state governments that the delay over the determination of the jurisdiction leads to avoidable wastage of time which impacts the victim and also leads to offenders getting an opportunity to slip from the clutches of law and that should be stopped.

Prashant Uikey <prashant.vikey@gmail.com>

 

Enclosing the copy of the circular. We at FEAT encourage citizens to take action against Police officers for delay / non-filing of FIR. In case you need any assitance please contact us.
Regards
 Milind Kotak <featindia@gmail.com>

FAQs on Will

FAQs on WILL

By CA Vimal Punmiya

Q.1  What is a Will and the benefits of making one?

Ans: A WILL is a written document in which you provide for:-

  1. the administration of your estate/assets when you die; and
  2. the distribution of your possessions in specific proportions to specific people whom you wish to have a share of your estate/assets;
  3. appoint a person or persons of your choice to administer your estate; and
  4. appoint a guardian or guardians for your infant children (if any).

In other words it a document where you direct, who is to receive your property upon your death. If you have any real property (land) or personal property (cars, jewelry, money) that you want to give to a specific person than you must have a will.

Q.2  Should everybody – working or non-working person, man or woman make a will? and  What if you die without making a Will

Ans: “Where there’s a Will, there’s a way….Where there is no Will, there will probably be family bitterness/family disputes…” If people die without a WILL, then the law will decide to whom the property of the deceased person should go to. Thus, every person whether working or non working , man or women should make a will.

Q.3 When should people make a will? At what age on an average?

Ans: Every adult, no matter what age, should have  a Will. Most preferably a person above the age 50 should have a will. And while making a Will a person must be of sound mind.

Q4  How do they make this will? Is there a process to making a will? What kind of paper is to be used? What language do they write it in? Do they need other people to witness the will?

Ans:  No prescribed form for a Will; only needs to be signed and attested

Click Here for more details

 

Political Parties come under RTI ambit

In a major victory to democracy, the Central Information Commission on 3rd June has ordered all political parties not only to designate PIOs and AAs within six weeks but also to abide by voluntary disclosures under Section 4 of the RTI Act

It took Right to Information (RTI) activists SubhasChandra Aggarwal and Anil Bahirwal, the national coordinator of National Election Watch and Association for Democratic Reforms, a good three years to collect incriminating evidence and tenaciously follow it up to prove that all political parties are public authorities. This fact was consistently resisted by spokespersons of the big political parties—Congress, Bharatiya Janata Party (BJP), Samajwadi Party (SP), Bahujan Samaj Party BSP as well as Nationalist Congress Party (NCP). The duo’s commendable efforts finally resulted in the Central Information Commission (CIC)delivering a landmark judgment on 3June 2013.

“Political parties have long resisted opening themselves to public scrutiny. People have long been demanding that there should be complete transparency in their financial and internal functioning. Various commissions including the Law Commission, Election Commission and NCRCW have already recommended that political parties should demonstrate transparency through various measures. The CIC should be immensely complimented for passing this landmark judgement to enable the citizens of India so that they can access information about the political parties for which they vote for.”

Click Here for the full story on this landmark judgement which is being opposed by all political parties.