In January this year, the cabinet approved listing of 5 public sector gener...
Central District Consumer Disputes Redressal Forum has ordered New India Assurance, one of the biggest public sector general insurance companies, to pay around Rs.60,000 as compensation to its policyholder Shiv Kumar Gupta.
Delhi-based Shiv Kumar Gupta holds a mediclaim policy from New India and he filed a claim of Rs.45,252 towards medical expenses incurred for his son. Mr. Gupta informed the third party administrator (TPA) of New India and submitted the requisite documents to the TPA for claim processing. But New India Assurance closed the claim processing on the grounds that in spite of several reminders, the policyholder did not provide the doctor's prescription slip and IPD paper.
However, neither the insurer nor the TPA could prove that they had sent out reminders to the policyholder. Therefore, the consumer court ruled the decision in favour of the claimant Shiv Kumar Gupta and asked New India to pay for the expenses incurred plus Rs. 10,000 as compensation against harassment and mental agony and Rs. 5,000 as litigation cost.
The authorised person of the forum, Mr. B B. Chaudhary said that the insurance company closed the claim without any valid reason and caused harassment and mental agony to the complainant.