In the career of a doctor there are some sticky situations. Insurance Medical examination is one of them. This is mainly because the scant respect the administrators and the agents have for the client, medical report or the doctor. I really do not understand the logistics of this. The payment for the doctor is still about Rs. 100 - while foreign insurance companies pay $ 250 per report! Cheap labor indeed . Again I do not understand this mentality particularly when the emoluments of the staff are increased almost on yearly basis for their work(?).
This story concerns one such medical examination a mandatory requirement before any insurance. A person was brought to me for a LIC Medical examination. I did not know the person though he is supposed to have been a well known person. He was accompanied by the ABM (Asst. Branch Manager) and the LIC agent . I requested both of them to identify the person and sign on my LIC diary for the same. I sincerely examined him. I found him feverish and surprisingly a little bit pale which was unusual as he was coming from a good family. I even commented about it and he promptly said he was suffering from cold.
The ABM and the agent took possession of the medical certificate, thanked me and left. I forgot about the episode till about 2 monthes later the agent told me in passing that the client died and that the claim (double benefit 4 lakhs for 2 lakhs policy) was promptly rejected by the LIC. I was not concerned anyway. Later I came to know that the party had filed a suit against the LIC. I did not bother about the details. Only when a person from the LIC Udupi division walked in a few days later for the "inquiry". Even then I did not assess the severity of the situation. I thought it was a routine inquiry because of early death which is a standard procedure. I was shell shocked when the person said the LIC had decided to file a criminal case against me. Why so?
He gave his version. The man was in a hospital admitted for a widespread cancer with spread to the bone, fracture of the spine and paralysis due to compression of the spinal cord. It was highly impossible that he could have come out of the room in the hospital leave alone visiting my clinic on the first floor. I got the implication. I had examined an impersonator. LIC wanted to file a criminal case against me for 'criminal involvement with the client for gain' . I was speechless. They gave me a week to reply
. I visited my lawyer friend in the evening and explained the situation to him. He heard me out and cooly said, "These things happen. Say sorry. Usually they leave you!" I was really upset. I had not committed the fraud. LIC officials had. To save them they were trying to make me the scapegoat. I sat up the night and gave it a serious thought at midnight when all is quiet and one can think without distraction.
I hit upon an idea which seemed to be foolproof. I wrote back saying " The person alleged to be so and so who was examined by me on the said date was indeed medically fit. However, the onus of identifying them lies with the persons who introduced him - in this instance - the ABM and the agent of LIC. So please forward your queries and inquiries to these two who in my opinion are hand in glove with the party and are the perpetrators to the crime".
The tone, and the content of the letter must have annoyed them. The LIC decided to take a second opinion from Nani Palkiwala. They wanted to silence me. I proactively wrote to them that I would be unilaterally proceeding for defamation charges with a claim of 1 crore for the mental harassment from LIC in order to save the fraudsters who were from LIC. The letter had the desired effect. Nani Palkiwala adviced LIC to lay off and behave. They apologised. The case was closed.
The moral of the story is to be very careful at all times. Fraudsters plan the escape roue in advance. Innocent one gets involved unless one is vigilant at all times!
This story concerns one such medical examination a mandatory requirement before any insurance. A person was brought to me for a LIC Medical examination. I did not know the person though he is supposed to have been a well known person. He was accompanied by the ABM (Asst. Branch Manager) and the LIC agent . I requested both of them to identify the person and sign on my LIC diary for the same. I sincerely examined him. I found him feverish and surprisingly a little bit pale which was unusual as he was coming from a good family. I even commented about it and he promptly said he was suffering from cold.
The ABM and the agent took possession of the medical certificate, thanked me and left. I forgot about the episode till about 2 monthes later the agent told me in passing that the client died and that the claim (double benefit 4 lakhs for 2 lakhs policy) was promptly rejected by the LIC. I was not concerned anyway. Later I came to know that the party had filed a suit against the LIC. I did not bother about the details. Only when a person from the LIC Udupi division walked in a few days later for the "inquiry". Even then I did not assess the severity of the situation. I thought it was a routine inquiry because of early death which is a standard procedure. I was shell shocked when the person said the LIC had decided to file a criminal case against me. Why so?
He gave his version. The man was in a hospital admitted for a widespread cancer with spread to the bone, fracture of the spine and paralysis due to compression of the spinal cord. It was highly impossible that he could have come out of the room in the hospital leave alone visiting my clinic on the first floor. I got the implication. I had examined an impersonator. LIC wanted to file a criminal case against me for 'criminal involvement with the client for gain' . I was speechless. They gave me a week to reply
. I visited my lawyer friend in the evening and explained the situation to him. He heard me out and cooly said, "These things happen. Say sorry. Usually they leave you!" I was really upset. I had not committed the fraud. LIC officials had. To save them they were trying to make me the scapegoat. I sat up the night and gave it a serious thought at midnight when all is quiet and one can think without distraction.
I hit upon an idea which seemed to be foolproof. I wrote back saying " The person alleged to be so and so who was examined by me on the said date was indeed medically fit. However, the onus of identifying them lies with the persons who introduced him - in this instance - the ABM and the agent of LIC. So please forward your queries and inquiries to these two who in my opinion are hand in glove with the party and are the perpetrators to the crime".
The tone, and the content of the letter must have annoyed them. The LIC decided to take a second opinion from Nani Palkiwala. They wanted to silence me. I proactively wrote to them that I would be unilaterally proceeding for defamation charges with a claim of 1 crore for the mental harassment from LIC in order to save the fraudsters who were from LIC. The letter had the desired effect. Nani Palkiwala adviced LIC to lay off and behave. They apologised. The case was closed.
The moral of the story is to be very careful at all times. Fraudsters plan the escape roue in advance. Innocent one gets involved unless one is vigilant at all times!
Sir,
ReplyDeleteNice reply to LIC people.
good lesson for us.
Thank you sir.
Need I say more; Sir, you nailed it...
ReplyDelete