Insurance firm directed to settle claims of patient
2 years, 7 months ago

Insurance firm directed to settle claims of patient

Deccan Chronicle  

Hyderabad: The District Consumer Disputes Redressal Commission-I directed the State Bank of India General Insurance to pay Rs 1,47,343 along with an interest at nine per cent for failing to settle the claims of a person who was insured with them and had undergone treatment. They filed a petition before the commission against Paramount Health Services and Insurance TPA services, State Bank of India and State Bank of India General Insurance seeking compensation after the insurance company failed to pay their hospital and treatment bills. The complainant stated that they had taken a family health insurance policy in 2015 from State Bank of India General Insurance through SBI. The commission directed SBI General Insurance to pay the claim amounts of Rs 49,683 and Rs 97,660 for an overall Rs 1,47,343 along with an interest of nine per cent from the date of payment till the date of realisation.

Insurance State Bank Settle Claims India General Insurance State Bank Of India General Insurance  rs  medical  hospital  pay  patient  india  bank  taken  directed  general  firm  state  settle  claims  insurance

History of this topic

How to ensure fair grievance redressal for health insurance claims? Know here
2 days, 12 hours ago

How to ensure fair grievance redressal for health insurance claims? Know here

India TV News  

Being denied a health insurance claim due to lack of documentation can be frustrating, but recent guidelines from the Insurance Regulatory and Development Authority of India aim to address the issue. Simplified documentation Insurers must provide a standardised review of documentation requirements at the time the policy is issued. Written explanation of rejections If the claim is denied, insurers must …

Unjustified Deductions: Delhi State Commission Holds Canara Bank And Bajaj Insurance Liable For Deficiency In Service
1 week, 4 days ago

Unjustified Deductions: Delhi State Commission Holds Canara Bank And Bajaj Insurance Liable For Deficiency In Service

Live Law  

The Delhi State Commission, presided by Justice Sangita Dhingra Sehgal and Ms. Pinki held Canara Bank and Bajaj Allianz Life Insurance liable for deficiency in service for unjustifiably deducting balance amount from the complainant's account. Brief Facts of the Case The complainant alleged that the Canara Bank, acting as a corporate agent for the Bajaj Allianz Life Insurance, pressured her …

Consumer Cases Weekly Round Up:[ 23rd December – 29th December 2024]
1 week, 4 days ago

Consumer Cases Weekly Round Up:[ 23rd December – 29th December 2024]

Live Law  

National Consumer Disputes Redressal Commission NCDRC Holds Bajaj Insurance Liable For Deficiency In Service Over Wrongful Repudiation Of Insurance Claim Case Title: Vasantiben Vs. Bajaj Allianz Life Insurance Company Ltd Case Number: R.P. Delhi State Commission Holds National Insurance Company Liable For Rejecting Claim Due To Bariatric Surgery Case Title: National Insurance Co. Ltd. Shanta Devi & Ors Case No: …

Baramulla Consumer District Commission Holds Insurance Company Liable For Non-Settlement Of Genuine Claim Amounts
1 week, 6 days ago

Baramulla Consumer District Commission Holds Insurance Company Liable For Non-Settlement Of Genuine Claim Amounts

Live Law  

The Baramulla District Consumer Disputes Redressal Commission has held Reliance General Insurance company liable for repudiating the genuine insurance claim of the complainant in an unreasonable manner. Brief background: The complainant purchased a vehicle truck TATA Signa from Fear Deal TATA motors in Srinagar and got it insured with Reliance General Insurance company for an amount of Rs. The Insurance …

Percentage Of No Claim Bonus Should Be Reduced From Claimed Amount: Uttarakhand State Commission Modifies Amount Awarded
2 weeks, 4 days ago

Percentage Of No Claim Bonus Should Be Reduced From Claimed Amount: Uttarakhand State Commission Modifies Amount Awarded

Live Law  

The State Consumer Disputes Redressal Commission, Uttarakhand presided by Ms. Kumkum Rani and Mr. B.S. Manral held that the percentage of No Claim Bonus that has already been availed from the previous insurance company should be reduced from the claimed amount by the complainant. Later, on 12.09.2016 the car was insured with United India Insurance Company Limited for the 2nd …

Uttarakhand State Commission Holds National Insurance Liable For Deficiency In Service Over Denial Of Legitimate Claim Amount
3 weeks, 1 day ago

Uttarakhand State Commission Holds National Insurance Liable For Deficiency In Service Over Denial Of Legitimate Claim Amount

Live Law  

The Uttarakhand State Commission, presided by Mr. M.K. Singh held National Insurance liable for deficiency in service and upheld the District Commission's order. Consequently, the insurer appealed before the State Commission of Uttarakhand. Contentions of the Insurer The insurer argued that the complainant breached policy terms and did not intimate the theft promptly. However, the complainant contended that the insurer …

Insured Cannot Assume Obligation On Part Of Bank To Renew Policy: NCDRC
3 weeks, 1 day ago

Insured Cannot Assume Obligation On Part Of Bank To Renew Policy: NCDRC

Live Law  

The National Consumer Disputes Redressal Commission, presided by AVM J. Rajendra overruled the State Commission's order against SBI and held that the insured cannot assume obligation on the bank's part to renew the policy unless agreed otherwise. The loan terms required the stock, machinery, and furniture to be insured with United India Insurance/insurer, with premiums deducted from the complainant's account. …

Burden of Proof On Insurer To Substantiate Reasons For Denial Of Claim : Telangana State Commission Holds LIC Liable For Deficiency In Service
1 month ago

Burden of Proof On Insurer To Substantiate Reasons For Denial Of Claim : Telangana State Commission Holds LIC Liable For Deficiency In Service

Live Law  

The Telangana State Commission, presided by Smt. V. V. Seshubabu held Life Insurance Corporation liable for deficiency in service and held that the burden of proof to prove the basis for the repudiation of claim lies with the insurer. Brief Facts of the Case The complainant's deceased husband had a life insurance policy worth Rs. Observations by the State Commission …

Reliance ordered to comply with ruling on health insurance claim
1 month ago

Reliance ordered to comply with ruling on health insurance claim

New Indian Express  

THIRUVANANTHAPURAM: A woman whose health insurance claim was rejected by Reliance Insurance Co Ltd “for want of essential documents” got relief from the State Consumer Disputes Redressal Commission. SCDRC’s order came on an appeal petition filed by the company against the favourable verdict obtained by the woman and her husband from the Kasaragod District Consumer Disputes Redressal Commission. SCDRC upheld …

Additional Claims Cannot Be Made Once The Claim Is Accepted Unconditionally: Uttarakhand State Commission Allows Insurance Company's Appeal
1 month ago

Additional Claims Cannot Be Made Once The Claim Is Accepted Unconditionally: Uttarakhand State Commission Allows Insurance Company's Appeal

Live Law  

The Uttarakhand State Consumer Disputes Redressal Commission bench of Ms. Kumkum Rani and Mr. B.S. Being aggrieved, the Complainant filed a complaint before the District Consumer Disputes Redressal Commission, Haridwar against the insurance company. Contentions of Reliance General Insurance Co. Ltd: The Appellant contended complainant was engaged in commercial activity and was not entitled to any compensation from the insurance …

Delhi State Commission Holds IFFCO-Tokio Liable For Deficiency In Service Over Wrongful Repudiation Of Claim
1 month ago

Delhi State Commission Holds IFFCO-Tokio Liable For Deficiency In Service Over Wrongful Repudiation Of Claim

Live Law  

The Delhi State Commission, presided by Justice Sangita Dhingra Sehgal and Ms. Pinki held IFFCO-Tokio General Insurance liable for deficiency in service over wrongful repudiation of a legitimate insurance claim. Contentions of the Insurer The insurer argued that the complainant is not a “consumer” under the Consumer Protection Act, 1986, as the insurance was bought for commercial purposes. Observations by …

Forcing Insured Person To Accept A Claim Less Than The Insured Value Amounts To Unfair Trade Practice: Chandigarh District Commission
1 month, 1 week ago

Forcing Insured Person To Accept A Claim Less Than The Insured Value Amounts To Unfair Trade Practice: Chandigarh District Commission

Live Law  

The Chandigarh District Consumer Disputes Redressal Commission has held that forcing the complainant insured person to accept only Rs.16,50,000 as full and final settlement as against the insured value of Rs. 22,00,000 would constitute unfair trade practice by New India Assurance Co. ltd. The Insurance Company argued that no case is made out for deficiency in service and unfair trade …

Rejection Of Claim Within Policy Waiting Period Not Deficiency In Service: Uttarakhand State Commission Allows Appeal By Universal Sompo General Insurance
1 month, 1 week ago

Rejection Of Claim Within Policy Waiting Period Not Deficiency In Service: Uttarakhand State Commission Allows Appeal By Universal Sompo General Insurance

Live Law  

The Uttarakhand State Commission, presided by Ms. Kumkum Rani and Mr. B.S. Manral held that an insurer's rejection of the claim due to the applicable waiting period under the policy does not constitute a deficiency in service. Observations by the State Commission The State Commission noted that the insurer had disallowed the claim on the grounds of the one year …

Anantapur District Commission Holds Shriram General Insurance Co. Liable For Wrongful Repudiation Of Valid Claim
1 month, 1 week ago

Anantapur District Commission Holds Shriram General Insurance Co. Liable For Wrongful Repudiation Of Valid Claim

Live Law  

The District Consumer Disputes Redressal Commission, Anantapur bench of Smt. D. Grace Mary and Sir B. Gopinath held 'Shriram General Insurance Company Limited' liable for deficiency in service for its failure to settle a valid claim amount assessed under IRDA approved survey findings. Observations of the Commission: The District Commission observed that the Insurance Company had appointed an IRDA-approved surveyor …

Injury Must Be Direct Cause Of Death To Claim Insurance Under Accidental Death: Telangana State Commission Dismisses Appeal Against United India Insurance
1 month, 1 week ago

Injury Must Be Direct Cause Of Death To Claim Insurance Under Accidental Death: Telangana State Commission Dismisses Appeal Against United India Insurance

Live Law  

The Telangana State Commission, presided by Smt. V. V. Seshubabu held that to claim the insurance policy under accidental death, the insured's death should directly have been caused by the injury in question. Observations by the State Commission The State Commission highlighted that the complainant's husband, while being taken to the operation theatre for a spinal fusion surgery, suffered a …

Kerala State Commission Upholds Order Against Reliance Insurance Company To Pay Treatment Expenses To Complainant
1 month, 2 weeks ago

Kerala State Commission Upholds Order Against Reliance Insurance Company To Pay Treatment Expenses To Complainant

Live Law  

While upholding the decision of the Kasaragod District Consumer Disputes Redressal Commission, the Kerala State Consumer Disputes Redressal Commission bench comprising of Mr. Justice B. Sudheendra Kumar, Mr. Ajith Kumar and Mr. Radhakrishnan K.R. Previously, District Commission had held Reliance Insurance liable for the deficiency of service for not paying the claim of the complainant who had taken coverage of …

[Motor Accident] Adverse Inference Can Be Drawn Against Insurer On Failure To Rebut Evidence: Jharkhand HC Upholds ₹11.45 Lakh Compensation
1 month, 3 weeks ago

[Motor Accident] Adverse Inference Can Be Drawn Against Insurer On Failure To Rebut Evidence: Jharkhand HC Upholds ₹11.45 Lakh Compensation

Live Law  

The Jharkhand High Court has upheld the award of ₹11,45,932 granted by the Motor Accident Claims Tribunal, Dhanbad, to the widow of a carpenter who succumbed to injuries sustained in a fatal motorcycle accident. The court emphasised that failure of the insurance company to summon key witnesses or rebut the evidence presented by the claimants resulted in an adverse inference …

Ernakulam District Commission - Internal Dispute Mechanism Under MEDISEP Scheme Doesn't Bar Aggrieved Persons From Approaching Commission
1 month, 3 weeks ago

Ernakulam District Commission - Internal Dispute Mechanism Under MEDISEP Scheme Doesn't Bar Aggrieved Persons From Approaching Commission

Live Law  

The District Consumer Disputes Redressal Commission, Ernakulam bench consisting of D.B. held that the existence of an internal grievance redressal mechanism under the Medical Insurance Scheme for State Employees and Pensioners does not exclude the Consumer Commission from entertaining the complaint. Background Facts Oriental Insurance argued that the complainant has not exhausted the grievance redressal mechanism provided under the Medical …

Bihar State Commission Holds Bajaj Allianz General Insurance Co. Liable For Wrongful Repudiation of Valid Claim
1 month, 4 weeks ago

Bihar State Commission Holds Bajaj Allianz General Insurance Co. Liable For Wrongful Repudiation of Valid Claim

Live Law  

The State Consumer Disputes Redressal Commission, Bihar bench of Gita Verma and Md. Shamim Akhtar held Bajaj Allianz General Insurance Co. Ltd. liable for deficiency in service for wrongfully repudiating a valid insurance claim despite receiving all required documents. The van was also insured with Bajaj Allianz General Insurance Co. Ltd., with a coverage of Rs. Based on the unchallenged …

Insurance firm cannot escape paying full compensation due to wrong entry: Madras High Court
2 months ago

Insurance firm cannot escape paying full compensation due to wrong entry: Madras High Court

New Indian Express  

CHENNAI: The Madras High Court has ordered an insurance company to pay full compensation amount to farmers affected by Gaja cyclone irrespective of the wrong entry made on the web portal concerned. A division bench of Justices of SS Sundar and AD Maria Clete passed the orders recently allowing an appeal filed by the Kumbakonam Central Cooperative Bank challenging a …

Terms Of Insurance Contracts Should Be Strictly Interpreted: NCDRC
3 months, 1 week ago

Terms Of Insurance Contracts Should Be Strictly Interpreted: NCDRC

Live Law  

The National Consumer Disputes Redressal Commission, presided by Mr. Subhash Chandra and Dr. Sadhna Shanker, dismissed an appeal against National Insurance Company and held that insurance contract terms must be strictly interpreted, with precise adherence to their explicit wording and no alterations made. Contentions of the Insurer The insurer contended that the complainants secured a home loan to purchase the …

Himachal Pradesh State Commission Holds United India Insurance Co. Liable For Wrongful Repudiation Of Valid Claim
3 months, 1 week ago

Himachal Pradesh State Commission Holds United India Insurance Co. Liable For Wrongful Repudiation Of Valid Claim

Live Law  

The State Consumer Disputes Redressal Commission, Himachal Pradesh bench of Justice Inder Singh Mehta held 'United India Insurance Company Limited' liable for wrongful repudiation of a medical claim based on erroneous interpretation of the policy's clauses. Observations of the State Commission: The State Commission observed the condition stated by the Insurance Company for repudiating the claim, was not applicable to …

Denial of full mediclaim: Court directs insurance firm to pay Rs 44k to customer in Ernakulam
4 months, 2 weeks ago

Denial of full mediclaim: Court directs insurance firm to pay Rs 44k to customer in Ernakulam

New Indian Express  

KOCHI: The Ernakulam District Consumer Disputes Redressal Commission ordered Oriental Insurance Company to pay the full insurance amount, along with compensation and cost of proceedings, to a customer for denying full medical insurance claim. However, the Commission found that the insurance company’s reliance on the “reasonable and customary charges” clause without providing any concrete evidence to support their deductions constituted …

East Godavari District Commission Holds Aditya Birla Health Insurance Co. Liable For Wrongful Repudiation Of Valid Claim
5 months, 1 week ago

East Godavari District Commission Holds Aditya Birla Health Insurance Co. Liable For Wrongful Repudiation Of Valid Claim

Live Law  

The District Consumer Disputes Redressal Commission, East Godavari bench of Sri D. Kodanda Rama Murthy, Sri S. Suresh Kumar and Smt. Lakshmi held Aditya Birla Health Insurance Company Ltd. liable for wrongful repudiation of a valid health insurance claim based on pre-existing diseases. Brief Facts: The Complainant obtained a health insurance policy from Aditya Birla Health Insurance Co. Ltd. for …

Ernakulam District Commission Holds Future Generali India Insurance Co. Liable For Wrongful Repudiation Of Genuine Medical Claim
5 months, 2 weeks ago

Ernakulam District Commission Holds Future Generali India Insurance Co. Liable For Wrongful Repudiation Of Genuine Medical Claim

Live Law  

The District Consumer Disputes Redressal Commission, Ernakulam bench of Shri D.B. held Future Generali India Insurance Company Ltd. liable for deficiency in service. Brief Facts: The Complainant took a Corona Rakshak Policy from Future Generali India Insurance Company Limited. Therefore, the District Commission held that the Insurance Company wrongfully repudiated the Complainant's claim. Case Title: Ajaychand V. vs Future Generali …

Consumer Complaints Must Be Lodged Within Two Years From Date Of Cause Of Action: Delhi State Commission
6 months ago

Consumer Complaints Must Be Lodged Within Two Years From Date Of Cause Of Action: Delhi State Commission

Live Law  

The Delhi State Commission, presided by Justice Sangita Dhingra Sehgal and Ms. Pinki, dismissed a complaint against Oriental Insurance Ltd., citing the presence of a limitation clause. It was further held that consumer complaints are time-barred and need to be filed within two years from the date of the action unless sufficient reasons are present. Observations by the State Commission …

South Mumbai District Commission Holds Bajaj Allianz General Insurance Co. Liable For Wrongful Repudiation Of Genuine Claim
6 months, 1 week ago

South Mumbai District Commission Holds Bajaj Allianz General Insurance Co. Liable For Wrongful Repudiation Of Genuine Claim

Live Law  

The District Consumer Disputes Redressal Commission, South Mumbai bench of P.G. Kapse and S.A. Petkar held Bajaj Allianz General Insurance liable for deficiency in services due to the repudiation of a genuine claim of theft. Feeling aggrieved, the Complainant filed a consumer complaint in the District Consumer Disputes Redressal Commission, South Mumbai, Maharashtra against the Insurance Company. The District Commission …

Courts Must Favour Complainant In Case Of Presence Of Two Interpretations Of Same Clause: Ernakulam District Commission
6 months, 1 week ago

Courts Must Favour Complainant In Case Of Presence Of Two Interpretations Of Same Clause: Ernakulam District Commission

Live Law  

The 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 …

No Proof Of Pre-Existing Disease, Kangra District Commission Holds Star Health And Allied Insurance Co Liable For Wrongful Repudiation
6 months, 3 weeks ago

No Proof Of Pre-Existing Disease, Kangra District Commission Holds Star Health And Allied Insurance Co Liable For Wrongful Repudiation

Live Law  

The District Consumer Disputes Redressal Commission, Kangra bench of Hemanshu Mishra, Arti Sood and Narayan Thakur held Star Health and Allied Insurance Co. Ltd liable for deficiency in services due to its unjustified rejection of a genuine claim. The bench held that the Insurance Company repudiated the claim without conducting a proper investigation or obtaining affidavits from treating doctors regarding …

Mere Deduction Of Premium Does Not Create Binding Insurance Contract, Uttarakhand State Commission Dismisses Appeal Against New India Assurance Co.
6 months, 4 weeks ago

Mere Deduction Of Premium Does Not Create Binding Insurance Contract, Uttarakhand State Commission Dismisses Appeal Against New India Assurance Co.

Live Law  

The State Consumer Disputes Redressal Commission, Uttarakhand bench of Kumkum Rani and Mr B.S. The bench dismissed an appeal filed against the New India Assurance Co. by holding that there existed no renewed insurance contract at the time of the loss and the Insurance Company refunded the premium which was automatically deducted by the bank. Feeling aggrieved, the Complainant filed …

Insurer to cough up ₹5 lakh for denying man’s medical claim
7 months, 1 week ago

Insurer to cough up ₹5 lakh for denying man’s medical claim

Hindustan Times  

The District Consumer Disputes Redressal Commission has directed an insurance company to pay ₹5 lakh, along with interest, to a local resident whose medical claim was denied. Along with ₹ 5 lakh, the insurance company has been directed to pay interest at 6% per annum. Filing a case against Max Bupa Health Insurance Company Limited, Lalit Kumar, a resident of …

Panipat District Commission Holds Muthoot Finance And Liberty General Insurance Co. Liable For Wrongful Repudiation Of Medical Claim
8 months, 2 weeks ago

Panipat District Commission Holds Muthoot Finance And Liberty General Insurance Co. Liable For Wrongful Repudiation Of Medical Claim

Live Law  

The District Consumer Disputes Redressal Commission, Panipat bench comprising Dr R.K. Dogra and Dr Rekha Chaudhary held Muthoot Finance Limited and Liberty General Insurance Company liable for deficiency in service for failure to reimburse the insurance claim even after receiving the requisite documents. Feeling aggrieved, the Complainant approached the District Consumer Disputes Redressal Commission, Panipat, Haryana and filed a consumer …

Consumer panel directs bank, insurer to pay ₹30 lakh claim to Mumbai cop injured in accident
9 months, 2 weeks ago

Consumer panel directs bank, insurer to pay ₹30 lakh claim to Mumbai cop injured in accident

Hindustan Times  

Mumbai, A consumer commission here has directed the Axis Bank and the New India Assurance company to pay an insurance claim of ₹30 lakh along with interest to a policeman who suffered injuries with permanent disabilities after an accident in 2017. HT Image The District Consumer Disputes Redressal Commission, South Mumbai, in an order passed on March 11, noted that …

Hisar District Commission Holds SBI General Insurance Co. Ltd. Liable For Dishonouring Fasal Beema Yojna, Delaying Inspection Of Crop Loss
10 months, 3 weeks ago

Hisar District Commission Holds SBI General Insurance Co. Ltd. Liable For Dishonouring Fasal Beema Yojna, Delaying Inspection Of Crop Loss

Live Law  

The District Consumer Disputes Redressal Commission, Hisar bench comprising Jagdeep Singh, Rajni Goyat and Dr Amita Agarwal held SBI General Insurance Company Ltd. liable for deficiency in services for failure to fulfil its duties under the operational guidelines of Fasal Beema Yojna. Despite the Complainant's timely intimation of loss, it held that the insurance company did not inspect the Complainant's …

Kerala consumer rights panel holds insurance company, bank accountable for medical claim denial
10 months, 3 weeks ago

Kerala consumer rights panel holds insurance company, bank accountable for medical claim denial

The Hindu  

In a major verdict, the Ernakulam Consumer Disputes Redressal Commission in Kerala has held a general insurance company and a bank that facilitated insurance coverage accountable for denial of medical insurance claim to a customer and directed them to pay a compensation of ₹2.23 lakh. Binu and members V. Ramachandran and Sreevidhia T.N., issued the verdict on a petition filed …

No Connection Between Pre-Existing Ailment And Death, Chandigarh District Commission Holds Canara HSBC Insurance Co. Liable
10 months, 4 weeks ago

No Connection Between Pre-Existing Ailment And Death, Chandigarh District Commission Holds Canara HSBC Insurance Co. Liable

Live Law  

The District Consumer Disputes Redressal Commission-I, Chandigarh bench comprising Pawanjit Singh, Surjeet Kaur and Suresh Kumar Sardana held Canara HSBC Insurance Company Ltd. liable for repudiation of the claim based on previous ailments without conducting medical examination of the insured before issuance of the policy. Alongside the loan, PNB offered a loan insurance policy from Canara HSBC Insurance Company Ltd. …

H.P. State Commission Holds Oriental Insurance Co. Liable For Repudiating Insurance Claim Solely Due To Delayed Intimation, Orders To Pay Rs. 7.9 Lakhs
10 months, 4 weeks ago

H.P. State Commission Holds Oriental Insurance Co. Liable For Repudiating Insurance Claim Solely Due To Delayed Intimation, Orders To Pay Rs. 7.9 Lakhs

Live Law  

The State Consumer Disputes Redressal Commission Shimla bench comprising Justice Inder Singh Mehta held Oriental Insurance Company Limited liable for deficiency in service for rejecting a claim solely only based on delayed intimation of the damage to the insurance company. The bench set aside the decision of the Shimla District Commission and directed the insurance company to the insurance claim …

Diabetes cannot be cited as reason to reject insurance claim
11 months, 1 week ago

Diabetes cannot be cited as reason to reject insurance claim

The Hindu  

Dakshina Kannada Consumer Disputes Redressal Commission has ruled that an insurance firm can’t reject the claim for reimbursement of treatment expenses on the ground that the claimant had diabetes mellitus for long. On December 9, 2022, the insurance firm rejected the claim on the ground that the claimant had diabetic mellitus for 27 years and it was a known case …

Chandigarh-based health insurance firm penalised ₹25,000 for rejecting mediclaim
1 year ago

Chandigarh-based health insurance firm penalised ₹25,000 for rejecting mediclaim

Hindustan Times  

The District Consumer Disputes Redressal Commission has penalised a city-based health insurance company for rejecting a cashless payment claim, citing that the medical record and the documents submitted by the hospital did not show any such medical condition and circumstances which necessitated OPD admission of the insured patient, and the hospitalisation and IPD treatment was not warranted. Parminder Singh, of …

Insurance company told to release Rs 3L med claim, slapped Rs 30k fine in TN
1 year ago

Insurance company told to release Rs 3L med claim, slapped Rs 30k fine in TN

New Indian Express  

VIRUDHUNAGAR: The District Consumer Disputes Redressal Commission in Srivilliputhur directed an insurance company to release a medical insurance claim of Rs 3 lakh to a customer and pay a fine of Rs 30,000 for deficiency in service. The commission, comprising President SJ Chakkkaravarthy and member M Muthulakshmi, issued the verdict after hearing a petition filed by G Selvaraj of Rajapalayam …

Gurdaspur District Commission Holds Punjab Gramin Bank And Bajaj Allianz Life Insurance Liable For Deficiency In Service For Misappropriation Of Cheque
1 year, 1 month ago

Gurdaspur District Commission Holds Punjab Gramin Bank And Bajaj Allianz Life Insurance Liable For Deficiency In Service For Misappropriation Of Cheque

Live Law  

The District Consumer Disputes Redressal Commission, Gurdaspur bench comprising Lalit Mohan Dogra and Bhagwan Singh Matharu held Punjab Gramin Bank and Bajaj Allianz Life Insurance Company liable for deficiency in services and unfair trade practices. Brief Facts; Surjit Singh had an account with Punjab Gramin Bank and had purchased a life insurance policy from Bajaj Allianz Life Insurance Company through …

Consumer Cases Weekly Round-Up: 9th October 2023 to 15th October 2023
1 year, 2 months ago

Consumer Cases Weekly Round-Up: 9th October 2023 to 15th October 2023

Live Law  

National Consumer Disputes Redressal Commission NCDRC Orders Haryana Transport Department To Pay Compensation For Its Failure To Prevent Smoking Inside Public Buses The National Consumer Disputes Redressal Commission bench comprising Dr Inder Jit Singh directed the Haryana State Transport Department to take appropriate measures to stop the menace of smoking inside the public buses by the drivers, conductors and passengers. …

Consequential Diagnosis To Treatment Must Be Reimbursed, Thane District Commission Holds Star Health And Allied Co. Liable
1 year, 3 months ago

Consequential Diagnosis To Treatment Must Be Reimbursed, Thane District Commission Holds Star Health And Allied Co. Liable

Live Law  

Recently, the Thane District Consumer Disputes Redressal Commission bench comprising V.C. Premchandani and Poonam V. Maharshi held Star Health And Allied Insurance Co. Ltd. liable of deficiency in service for rejecting the insurance claim filed by the complainant for expenses he incurred during his treatment at Jupiter Lifeline Hospital Ltd.. Brief Facts of the Case: In 2013, Mr. Diliprao D. …

Do Not Deny Insurance Claim For Brief Home Visit During Hospitalization, Ludhiana Commission Holds Aditya Birla Health Insurance Co. Liable
1 year, 3 months ago

Do Not Deny Insurance Claim For Brief Home Visit During Hospitalization, Ludhiana Commission Holds Aditya Birla Health Insurance Co. Liable

Live Law  

The District Consumer Disputes Redressal Commission, Ludhiana bench comprising Sh. Sanjeev Batra and Ms. Monika Bhagat held Aditya Birla Health Insurance Company liable for rejecting the claim of the hospitalized Complainant on the basis that the Complainant visited his home for certain hours while he was hospitalized. However, the insurance company rejected his claim, asserting that the Complainant had occasionally …

Chandigarh: Insurer penalised for rejecting mishap victim’s mediclaim
1 year, 4 months ago

Chandigarh: Insurer penalised for rejecting mishap victim’s mediclaim

Hindustan Times  

A Zirakpur woman, who had approached the District Consumer Disputes Redressal Commission, Chandigarh, over rejection of mediclaim by the insurer following an accident, has been awarded the complete claim, along with compensation for mental harassment. The consumer commission directed Religare Health Insurance Company Limited to pay the claim amount along with compensation. The commission directed Religare Health Insurance Company Limited …

92-yr-old Chandigarh man wins legal fight against wrongly rejected mediclaim
1 year, 8 months ago

92-yr-old Chandigarh man wins legal fight against wrongly rejected mediclaim

Hindustan Times  

Wrongly rejecting a 92-year-old man’s medical claim has cost an insurance firm dear. The 92-year-old alleged that despite the fact that the claim was fully covered as per the terms and conditions of the policy, the company wrongly repudiated it, which amounted to deficiency in service and unfair trade practice. Holding New India Assurance Co. Limited, Chandigarh, guilty of unfair …

Gujarat Consumer Court Orders Insurance Company to Cover Doctor's Medical Bills after Treatment at Own Hospital
2 years, 6 months ago

Gujarat Consumer Court Orders Insurance Company to Cover Doctor's Medical Bills after Treatment at Own Hospital

News 18  

A Gujarat court has ordered that a doctor is entitled to medical insurance claim for treatment in his own hospital. The petitioner, Dr Indravadan Shah, had filed a complaint in the Consumer Protection Court in June 2021 against Niva Bupa Insurance for non-payment of claim. The insurance company rejected the claim.” The claim was rejected as the doctor was treated …

Motor Accident Claim: Allahabad High Court Imposes ₹5 Lakhs Cost On Insurance Co. For 'Keeping Litigation Alive' For 20 Yrs
2 years, 9 months ago

Motor Accident Claim: Allahabad High Court Imposes ₹5 Lakhs Cost On Insurance Co. For 'Keeping Litigation Alive' For 20 Yrs

Live Law  

The Allahabad High Court recently imposed Rupees Five Lakhs on an insurance company while noting that it kept the litigation alive for almost 20 years in connection with a Motor Accident Claims case.The Bench of Justice Dinesh Kumar Singh imposed the exemplary cost on the Insurance Company as they made the complainant and her five. The Allahabad High Court recently …

Delhi High Court Seeks Response From IRDAI On Plea Alleging Failure To Protect Interests Of Policy Holders
3 years, 9 months ago

Delhi High Court Seeks Response From IRDAI On Plea Alleging Failure To Protect Interests Of Policy Holders

Live Law  

The Delhi High Court has sought response from the Insurance Regulatory Development Authority of India on a petition alleging inaction on its part for protecting the interest of various policy holders. Under Section 14 of the IRDAI Act, 1999, the authority is entrusted to protect the interests of policy holders in matters concerning assigning of policy, settlement of insurance claims, …

Discover Related