National Insurance Co. To pay Rs 2.5 L medical claim to woman
13 May, 2014 12:12 PM
National Insurance Company Ltd has been directed to pay Rs 2.5 lakh as medical cover to a woman, who underwent a surgery, by a consumer forum which said the firm was "unjustified" in denying the claim and it tantamounts to "deficiency-in-service".

The South West Delhi District Consumer Disputes Redressal Forum, presided by S K Sarvaria, said there was no reason for denying the insurance claim to the woman and asked the firm to pay the money being the "insurance cover amount under the policy against the expenses incurred by her on her treatment during the validity period".

"...From the clarification of Dr Gupta (who diagnosed the woman's disease in 2007) and categorical denial made on oath by the complainant (woman) that she had (earlier) suffered from any disease diagnosed as TB, we find that the reason for rejecting the claim of the complainant by the opposite party (insurance company) was unjustified and tantamounts to deficiency-in- service as defined Under the Act," the forum, also comprising its member Harshali Kaur, said.

The forum passed the order on the complaint of Seema Sharma, a south Delhi resident, against National Insurance Company Ltd, seeking medical claim for the expenses incurred by her during her treatment in 2007, besides the compensation.
Source : Business Standard

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