Q: One of my friends met with an accident when he had gone home on vacation. He had multiple fractures and he was not in a position to travel back. He stayed back home for more than 90 days the standard condition prescribed under his Medical Policy. The insurance company has rejected his claim citing the above condition. Is his claim is payable? A: There is a standard condition under International Medical Insurance policy that will automatically cover the vacations/living outside the Kingdom and or foreign trips up to 90 days and if the period of stay in the foreign country is beyond 90 days then the claim is not payable. There are other requirements like timely submission of claim may be within 30 to 60 days, prior intimation to the insurer, type of treatment undertaken, customary pricing etc. Some companies exclude two wheeler driving and riding hence make sure that it has all the compliances. If the accident had occurred within 90 days of his stay outside the Kingdom and due to his health condition he could not travel, then there is a clear cut justification that his claim is payable. He should re-submit the claim to the insurance company and try to convince them about the reasons for his stay beyond 90 days was purely related to the accident and the treatment was related to it. He was also in no condition to return to Saudi Arabia and resume his job. Q: I am working for an insurance company for almost a decade. I am in the technical department and look after marine insurance. Now I feel that I have no chances of growth and I am not getting adequate exposure to insurance as I should get. Recently I got selected by an industrial organization for the job of an insurance coordinator. It is really confusing, whether should I take up this job? A: As a insurance coordinator, you will get a good experience of dealing with various insurance companies and will get an opportunity to get exposed to different types of insurance coverage like motor, property, contract work liability, medical etc. This may give you a thrust when you decide to return back to insurance company or brokerage. On the growth front, once again there will be no opportunity as an insurance coordinator unless you have an aptitude for accounts or human resources and are willing to move in those areas. Since you are already working for an insurance company and are in the technical department, I suggest you to seriously explore the opportunities within your company before you take up this job. * Shujaath Ahmed Khan, an MBA, General Manager, Creative Associates is also a consultant and an expert in Insurance, Investments and Real Estate. He can be contacted at [email protected], website-www.creativeassociates.blogspot.com __
