
Courts Must Favour Complainant In Case Of Presence Of Two Interpretations Of Same Clause: Ernakulam District Commission
Live LawThe Ernakulam District Commission, presided by Shri. Sreevidhia T.N., held Star Health & Allied Insurance liable for deficiency in service and unfair trade practice. The insurer maintained there was no deficiency in service or unfair trade practice, contested the ₹1,20,000 hospitalization expenses, and argued any liability should be limited to ₹95,286, excluding non-medical expenses. Observations by the District Commission The District Commission observed that the insurer's refusal to process the claim, despite receiving substantial documentation and the treating doctor's certification, demonstrated a clear deficiency in service. Applying this principle, the insurer's denial of the claim based on technicalities and unnecessary documentation requirements was unjustified and constituted unfair trade practices.
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