Mediclaim policy does not cover congenital diseases

In December 2009, I had purchased a mediclaim policy under platinum policy conditions of United India Insurance Co Ltd in the name of my 18-year-old son.  On March 9, 2011, he was admitted to a hospital and on March 11, 2011, he had a Laparoscopic Tanner’s operation. I have incurred hospital expenses of Rs80,000.  My claim was rejected by the TPA saying the disease was in-born. If I approach the insurance company, is there a chance they will revise this decision, as till the age of 18, there were no symptoms of the disease? Please advise.
The policy does not cover treatment costs incurred for congenital disease (or in other words a disease or condition that a person is born with). This exclusion, unfortunately, is universal whether you were aware of the condition or not. To prove your son’s stated disease is not congenital, you need to consult doctors. If most of them opine that the condition was not congenital, you can log a complaint on the company’s website. If they don’t reply to you within a period of 2-3 weeks, please approach the Insurance Ombudsman with your complaint for redressal.

How does the insurance company calculate “loading charge” on the premium for next year’s premium if your claim is within the limit of total sum assured?
For policies issued after July 1, 2009, the policy document has to mention the loading conditions and also the extent to which it would be done. So, examine your policy if such a loading condition is mentioned. If not, then the company cannot load the premium.

If the property (for which I have taken a home loan) comes under some kind of legal dispute or if the builder stops construction, what will happen to the loan? Will I need to keep paying EMI? How will property insurance help in such cases?
In cases where the property on which the loan has been taken goes under dispute, the borrower is still obliged to keep paying the EMI. Giving of loan by a bank on specific property does not carry any warranty of waiver or moratorium of payment of EMI.
Property insurance does not cover risks on matters pertaining to delay due to builder’s fault or legal dispute. You are still liable to pay the home loan EMIs to your bank to avoid being a defaulter. Basically, it is the buyer (you) who is responsible for checking the property title or the possibilities of a delay in construction and the risks incidental thereto. Title insurance is still not available in India.

Is it possible for the bank to hold the loan before disbursement once the loan amount is approved and approval mail/SMS sent by the bank? If not, then can we take any legal action against the bank if they are not willing to give loan even after approval?
You have a right to get the reasons in writing if the bank is withholding disbursements due to any reason. If you are not satisfied with the reasons given by the bank or the bank does not respond within 30 days of your writing, you should complain to the Banking Ombudsman. For details, log on to www.bankingombudsman.rbi.org.in.

The writer is CEO, Apna Paisa, a price & features
comparison engine for loans, insurance and investments.
He can be reached at hrdna@apnapaisa.com