Terms Of Use
This agreement is between Hereinafter called and referred to as “The Client/User/You” (Which expression shall unless repugnant to the context or meaning thereof shall mean and include his/her/their legal heirs, successors, legal representatives and permitted assigns, etc) the Party of the First Part; AND M/s Mpathy Mediclaim Consultancy LLP, A Limited Liability Partnership Firm Having its registered Office No: 5, 3rd Floor, Yash Coronet Apartments, FC Road, Above Champion Sports, Deccan Gymkhana, Pune, Maharashtra – 411004, Through its duly authorized Partner Mr. Sachin S Mahajan Age 54 Years– Adult, Occupation – Business.
Hereinafter called and referred to as “The Consultant Mpathy” (Which expression shall unless repugnant to the context or meaning thereof shall mean and include its present and future partners, successors, and permitted assigns, etc.) the Party of the Second Part; “The Consultant” and “The Client” are hereinafter jointly referred to as “Parties” and individually as “Party”. Whereas,
1) The Consultant is engaged in the business of providing assistance in resolving consumer grievances by representing the Client before the Ombudsman, Insurance Companies, representing at Consumer Forums/ Courts by appointing an Advocate thereof, in respect of any dispute arising out of any Life insurance, Health insurance and General insurance.
2) The client has approached the Consultant to avail the services of Mpathy to assist the Client in initiating requisite actions against the insurance company for various reasons which are shared in writing over email by the Client to the Consultant.
3) After understanding services the Client has agreed and decided to engage and appoint a Consultant to resolve the said dispute against the insurance company against which the Client has agreed and irrevocably undertaken to pay the price as stated hereinafter.
Now, This Agreement Witnesseth As Under
- Services
The Client do hereby appoint and authorize the Consultant to do the needful for resolving the insurance dispute/issue as informed by client in writing over email and Client agrees to pay the price in the manner as stated hereinafter and the Consultant hereby agrees to provide its services for resolving the dispute/issues related to consumer grievance which shall include following scope of work and nothing beyond it :
1) To draft application(s) to the company or concerned authorities for various issues.
2) To use legal and quasi legal methods and to draft all the necessary legal documents like affidavits, indemnity bonds, contracts, complaints, written submissions etc.
3) To send legal notices and the replies, and helping Client with all the steps which are necessary to be undertaken by the Client.
Terms & Conditions
1) The Consultant after discussing the merits of the case(s) can decide internally to proceed with the case or reject it by explaining the reason for the same. In case of rejection by the Consultant, the Agreement shall be considered null and void.
2) The Client does hereby appoint and authorize the Consultant to represent the Client before any insurance company officer, ombudsman, etc, and hereby further undertake to execute necessary forms, applications, complaints, appeals, etc, as shall, and /or execute power of attorney in favour of Consultant, if required, at the costs, efforts of Client.
3) This Agreement shall commence on the date of acceptance of this mail and the same shall remain in effect until the completion of the services. The Consultant shall be entitled to terminate this Agreement immediately, in the event that the Consultant becomes aware of the fact that the client has provided forged/bogus/false documents or information thereby showing the wrong intention of the client to mislead the Consultant, insurance company and/or Client is not the person in whose name such insurance is.
Price/ Fees & Process
1) Client agrees to provide all required documents and disclaimer to consultant for checking and confirming claim admissibility for which consultancy will not charge any fee.
2) After confirmation of the claim admissibility by the consultant, client agrees to pay the registration and processing fee as mentioned in the excel sheet which will be non-refundable.
3) Once Client agrees to pay above amount the Consultant shall provide Client with its advice as to: whether the claim is payable or not and same shall be informed within 7 working days from the date of receiving the registration 7 processing fees, and timeline of 7 days shall be excluding force majeure events such as lockdowns, floods, strikes, insurance companies closed, any reason beyond the control of parties herein.
4) We charge Fee as mentioned in excel sheet given below which is to be paid in advance to our account via online payment or cheque, which will be non-refundable.
5) In case the claim doesn’t get settled in spite of our appeal to company, IRDAI and Ombudsman, Consumer forum, we will not be responsible for the same as it’s beyond our control.
6) If it is found that the client has suppressed any crucial information from us (such as Pre-Existing Diseases /conditions, material information regarding his claim etc.), then Consultant shall retain entire fee received in advance and shall return the documents and will not continue consultancy and this agreement shall stand terminated.
7) The Client hereby agrees and undertakes that in case the Consultant decides to approach any Court/Forum/Tribunal, the Client shall give its consent /POA to the Consultant in advance to do needful and the Client shall be apprised of the related expenses in approaching the Court/Forum/Tribunal. The actual cost of litigation, expenses, advocates fees, court fees, stationary, cost for obtaining certified copies, outstation travel expenses, etc. arising thereof shall be apprised to the Client before hand and the Client hereby agrees and undertakes to make the payment within the period of seven days thereof, failing which the Client shall be liable to pay interest on such dues along with interest @ 24% per annum on dues, and the Consultant shall not be liable to pursue the terms of this agreement nor perform any duties undertaken by it under this agreement and the Consultant reserves right to terminate this agreement and recover amounts from Client.
Fee structure
| Claim Amount | Amount (Rupees) |
|---|---|
| Upto Rs.1 Lac | 4000 |
| 1.01 Lacs to Rs.2 Lacs | 5000 |
| 2.01 Lacs to 3 Lacs | 7000 |
| 3.01 Lacs to 5 Lacs | 10000 |
| 5.01 Lacs to 7 Lacs | 15000 |
| 7.01 Lacs and above | 20000 |
Undertaking & Indemnity
1) The Client hereby agrees and undertakes that Client is a legal policy holder / nominee / assignee or authorized representative.
2) The Client hereby agrees and undertakes to authorize the Consultant to assist the client at various forums, officials and not appoint any third party during effect of this agreement.
3) The Client undertakes to provide the signatures and the required documents like Pan Card, Aadhar, Address Proof, ITR etc. of the Surety/ Guarantor required for processing the case.
4) The Client hereby agrees and undertakes that he or she shall sign all the forms, applications, documents, undertakings, indemnity bonds, power of attorney, writings, as shall be required by anybody for the successful completion of the work.
5) The Client hereby agrees to comply with legal formalities/procedures and all the communication to be done between client and companies/ RTAs/ or any other concerned authorities shall be routed through the Consultant.
6) The Client hereby agrees and undertakes that the entire scenario of case has been explained by him to the consultant and the duration of completion of service by the consultant is not time bound.
7) The Clients consents to the use of the reviews/testimonial given by him for the sole purpose of spreading awareness and further promotion of the Consultant business.
8) The Client hereby agrees to defend, indemnify and hold harmless the Consultant and its directors, officers, and employees with respect to a claim arising from the Client’s actual or alleged act, failure to act, error, or omission in the performance of their obligations under this Agreement or any governing law or regulation.
9) It is clear between parties that, the consultant does not guarantee any outcome while providing its services to the client, and client hereby undertakes to be bound by the outcome, award passed by any ombudsman, forum, tribunal, etc.
Entire Agreement
This Agreement constitutes the complete agreement and sets forth the entire understanding and agreement of the parties as to the subject matter of this Agreement and supersedes all prior discussions and negotiations or business dealing, customary practice evolved any previous business between them and the parties shall not be bound by any conditions, definitions, warranties, representations and negotiations whether oral or written or made earlier to executions of this agreement
Modification
This Agreement shall not be subject to any change or modification, except otherwise by the execution of any amendment of instrument shall be in separate writing by and between the Parities herein.
Dispute Resolution
9.1 Any dispute, controversy, disagreement or disputed claim arising out of, in connection with or under this Agreement or the breach, termination, interpretation or invalidity thereof or in relation to any matters contained in or relating to this Agreement raised by any Party (each a ‘Dispute’) shall be attempted to be resolved by the Parties by good faith negotiations in the best interest of the subject-matter of this Agreement within 30 (thirty) days thereof, failing which, either Party shall be entitled to seek adjudication of such Dispute by arbitration as provided herein.
Jurisdiction
The Courts at Pune shall have exclusive jurisdiction to try and adjudicate all suits, actions and proceedings arising out of this Agreement the cost of which shall be entirely borne and payable by the Client. By ticking the check box, THE CLIENT HEREBY EXPRESSLY AGREES TO AND CONSENTS TO BE BOUND BY ALL OF THE TERMS OF THIS AGREEMENT.