The District Consumer Disputes Redressal Forum has directed an insurance company to pay medical insurance to a local resident, whose claim was not being decided by the company stating that he had not submitted relevant documents.
Deciding in favour of the complainant, the forum observed that the insurance company was delaying the payment of claim unnecessarily.
The company had also been directed to pay Rs 5,000 as compensation and Rs 2,000 as litigation expenses.
Earlier, Ashwani Bhatia, a resident of Sharifpura, had filed a complaint against United India Insurance Company stating that he had purchased a medical insurance policy from the opposite party.
He stated that during the validity of the policy, he fell ill and was hospitalised where he spent Rs 23,139 on his treatment.
He complained that the opposite party had been using dilly-dallying tactics to decide his claim for medical reimbursement.
The opposite party, in its reply, stated that the complainant had not submitted some relevant papers concerning his medical treatment with their office.
The forum observed that the fact of filing the claim form had been duly admitted by the opposite party in its reply.
It stated that it was the case of the opposite party that no doubt the complainant submitted the claim form, certain documents as detailed in the written statement, were not supplied to the opposite party for deciding the claim.
The forum said the contention of the opposite party did not appear to be tenable because the claim form contained the list of the documents which were supplied with it.
The forum stated that insurance companies showed green pastures to the people at the time of selling the insurance policy but when it came to the payment of the insurance claim, they invented all sort of excuses to deny the claim.
Curated from Insurance firm told to pay compensation to resident