AHMEDABAD, SEPT 25: The consumer disputes redressal forum here has ruled as illegal rejection of a policy holder's claim by the United India Insurance Company under the Mediclaim Scheme and ordered to pay Rs 7,947 to her with 18 per cent interest from November 1, 1995.The forum has also directed the insurance company to pay Rs 2,000 each as costs to the policy holder, Sulochana Chandravadan, and Consumer Education Research Society (CERS), Ahmedabad, which had lodged the complaint.
According to the complaint, Sulochana had taken a mediclaim policy from the insurance company in 1993 and it expired on December 14, 1994. However, she renewed the policy on December 26 in the same year.
She had undergone an eye operation for cataract on July 3, 1995 and filed a claim for Rs 7,946.50.
The insurance company repudiated her claim on the grounds that it was a fresh policy and the claim for cataract comes under the exclusion clause of the policy.
She argued that since the policy was renewed, it could not becalled a fresh one and the insurance company had illegally repudiated her claim.
Allowing the complaint, the forum observed that since Sulochana had been given a 10 per cent discount on the premium and a cumulative bonus at the time of renewing it, the company had in fact treated the policy as renewed and committed an error in treating it as a fresh policy.
Copyright © 1998 Indian Express Newspapers (Bombay) Ltd.