My father suffered a major accident resulting in multiple fractures and brain injury. Even though he recovered physically, he lost his memory and he needs constant care by a person 24x7. My company has medical coverage for my father too. My company's medical insurance took care of 60% of the medical expenses. In the process, they too all original bills and they said they will never return the original bills. Since it was a motor accident, my father can get compensation from the culprit's motor insurance.FIR was filed and case was initiated. But the lawyer says, he needs all the original bills of the medical expenses to have compensation under Motor Accidents Claims Tribunal (MACT). My company's medical insurer says they can give a letter stating 60% of the medical expenses were reimbursed by them and rest of 40% can be claimed from MACT. I also have photostat copies of the medical expense bills, discharge summary, scan reports and every thing that is needed. Can you please let me know if MACT claim will be successful with attested photostat copies of medical expenses and a letter from the medical insurer stating that a percent of expenses have been reimbursed by them and the rest can be claimed from someone else?
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1) obtain certified copy of medical reports , expenses bill from the hospital
2) request the hospital to certify the photostat copies as true copy
3) you can rely upon medical insurer letter that they have paid only 60 per cent of bill
4) mere photostat copies would not be acceptable by MACT
Hello,
1) Although the original bills have to be produced before the MACT to succeed in the claim, there can be exceptions in your case as you are making a partial claim. You need to let the court know pro actively that you do not possess the original bills as they have been submitted to the first insurer through your company and you needed urgent help then.
2) Your lawyer must convince the tribunal that yours is an exceptional case and the victim, your father has not recovered fully yet and has become totally dependent.The letter from the company and the certified copies of the bill can help your cause. Produce a recent medical certificate before the tribunal to drive home your point.
3) What you need to do is to obtain claim settlement summary from the first insurer and get the photocopies attested by the hospital and submit these both to the second insurer. If the insurer refuses to honour the claim the tribunal will order in your favour.
MACT will consider all the bill even if the bill are attested photocopies, there is a procedure by which you can summon to insurance company and they have to produced original bills before the court, so no need to worry, you can claim all the amount from insurance company of offending vehicle.
Not only the expenses the insurance or offender shall be liable to pay compensation for your loss.
You first file a MACT case claiming insurance amount based on the copies of the bills and other medical records.
Let the court advise you to produce the original documents or a certified or authenticated copy of the documents/medical bills. You can decide about approaching another lawyer who can handle the case without the originals.
It is not necessary that you should hang around only one lawyer who has opined his way. There is no dearth for MACT lawyer and an efficient lawyer dealing with only MACT cases knows how to penetrate inside and get the desired reliefs.
