Ernakulam District Commission - Internal Dispute Mechanism Under MEDISEP Scheme Doesn't Bar Aggrieved Persons From Approaching Commission
4 months 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 Insurance Scheme for State Employees and Pensioners scheme. Vs. Hindustan Safety Glassworks Ltd. where it was held that the existence of an internal grievance redressal mechanism does not exclude the jurisdiction of the Consumer Commission. The Commission held that the existence of an internal grievance redressal mechanism under the MEDISEP scheme does not exclude the jurisdiction of the Consumer Commission.

Insurance Pensioners Scheme District Commission Consumer Dispute Oriental Insurance State Employees Medisep Medisep Scheme  employees  persons  district  commission  insurance  consumer  dispute  doesnt  pensioners  state  mechanism  grievance  ernakulam  internal  redressal  scheme  medisep

History of this topic

Insurance firms draw flak for misinterpreting ‘pre-existing illness’ clause
2 weeks ago

Insurance firms draw flak for misinterpreting ‘pre-existing illness’ clause

New Indian Express  

THIRUVANANTHAPURAM: The State Consumer Disputes Redressal Commission has criticised insurance companies for misinterpreting the clause on “pre-existing illness” to reject legitimate claims. While disposing of a case related to a claim rejection by the Life Insurance Corporation of India, the commission clarified that a pre-existing disease pertains to treatment received within 48 months prior to the issuance of the first …

National Insurance Company Held Liable For Deficiency In Service For Denying Full Policy Amount To Complainant
1 month ago

National Insurance Company Held Liable For Deficiency In Service For Denying Full Policy Amount To Complainant

Live Law  

The District Consumer District Redressal Commission Ernakulam held National Insurance Company Ltd liable for deficiency in service. Claiming the entitlement to receive the rest of the amount, the Complainant approached the Opposite Party stating that the Opposite Party was required to ensure the full payment of the policy amount. Hence, the Complainant approached the District Consumer Disputes Redressal Commission Ernakulam …

Consumer Protection Act 2019 | State Commission Can't Dismiss Compliant For Non-Prosecution, Obliged To Give Decision On Merits: Kerala HC
1 month, 1 week ago

Consumer Protection Act 2019 | State Commission Can't Dismiss Compliant For Non-Prosecution, Obliged To Give Decision On Merits: Kerala HC

Live Law  

The Kerala High Court has ruled that the State Consumer Disputes Redressal Commission cannot dismiss a complaint for default or non-prosecution. The Court thus held that the State Consumer Disputes Redressal Commission is obliged to decide the complaint on merits, and cannot dismiss it on default or for non-prosecution. In the facts of the case, the petitioner filed a complaint …

Health insurance claims: How to ensure fair grievance redressal
2 months, 1 week ago

Health insurance claims: How to ensure fair grievance redressal

Live Mint  

My health insurance company has rejected my claim because I am unable to furnish internal hospital papers. —Name withheld on request If your insurance claim has been rejected due to lack of documentation, it’s essential to understand your rights under the latest guidelines from the Insurance Regulatory and Development Authority of India. Insurers must assist policyholders in identifying missing documents …

How to ensure fair grievance redressal for health insurance claims? Know here
2 months, 1 week 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 …

Consumer Cases Weekly Round Up:[ 23rd December – 29th December 2024]
2 months, 3 weeks 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: …

Kerala State Commission Upholds Order Against Reliance Insurance Company To Pay Treatment Expenses To Complainant
3 months, 3 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 …

Bihar State Commission Holds Bajaj Allianz General Insurance Co. Liable For Wrongful Repudiation of Valid Claim
4 months, 1 week 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 …

Himachal Pradesh State Commission Holds United India Insurance Co. Liable For Wrongful Repudiation Of Valid Claim
5 months, 3 weeks 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
6 months, 3 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 …

Consumer Cases Weekly Round-Up: 22nd To 28th July 2024
7 months, 3 weeks ago

Consumer Cases Weekly Round-Up: 22nd To 28th July 2024

Live Law  

State Consumer Disputes Redressal Commission, Goa Insurer Not Liable For Unreasonable Delay In Claim Intimation, Goa State Commission Dismisses Appeal Against Oriental Insurance Company The State Consumer Disputes Redressal Commission, Goa bench comprising Mrs Varsha R. Bale and Ms Rachna Anna Maria Gonsalves dismissed an appeal against Oriental Insurance Company, based on an unreasonable delay on the Complainant's part while …

Ernakulam District Commission Holds Visudha Sadhu Janasangham Liable For Failure To Disburse Promised Cremation Benefits
7 months, 3 weeks ago

Ernakulam District Commission Holds Visudha Sadhu Janasangham Liable For Failure To Disburse Promised Cremation Benefits

Live Law  

The District Consumer Disputes Redressal Commission, Ernakulam bench of Shri D.B. held Visudha Sadhu Janasangham, Thoppumpady liable for failure to give promised cremation benefits to its shareholders as per its binding bye-laws. After several failed attempts to resolve the issue with the Sangham, the Complainants sent a lawyer's notice and received a reply, which denied any service deficiency. Feeling aggrieved, …

Ernakulam District Commission Holds Future Generali India Insurance Co. Liable For Wrongful Repudiation Of Genuine Medical Claim
7 months, 3 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 Cases Monthly Digest: June 2024
8 months ago

Consumer Cases Monthly Digest: June 2024

Live Law  

National Consumer Disputes Redressal Commission Limitation Period Under Policy Is Shorter Than Statutory Period For Filing Complaint, Unenforceable And Void: NCDRC Holds Oriental Insurance Liable For Deficiency In Service The National Consumer Disputes Redressal Commission, presided by Subhash Chandra and Sadhna Shanker, held that the Consumer Protection Act 1986 provides a two-year limitation period for filing a complaint, and the …

Courts Must Favour Complainant In Case Of Presence Of Two Interpretations Of Same Clause: Ernakulam District Commission
8 months, 3 weeks 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 …

Consumer Cases Weekly Round-Up: 20th To 26th May 2024
9 months, 3 weeks ago

Consumer Cases Weekly Round-Up: 20th To 26th May 2024

Live Law  

National Consumer Disputes Redressal Commission Alerting Insurer About Renewal Of Insurance Is Bank's Responsibility: NCDRC Holds Syndicate Bank Liable For Deficiency In Service Case Title: Bank Manager, Syndicate Bank Vs. Ishwar Dayal The National Consumer Disputes Redressal Commission, presided by Dr. Inder Jit Singh, held Syndicate Bank liable for deficiency in service and held that it is the responsibility of …

Consumer Cases Weekly Round-Up: 25th to 31st March, 2024
11 months, 2 weeks ago

Consumer Cases Weekly Round-Up: 25th to 31st March, 2024

Live Law  

National Consumer Disputes Redressal Commission Damages Involving Motor Vehicles Must Be Adjudicated By Motor Accident Claim Tribunal, Consumer Forums Do Not Have Jurisdiction: NCDRC The National Consumer Disputes Redressal Commission bench comprising Mr Justice Sudip Ahluwalia reiterated that Consumer Fora do not have the jurisdiction to entertain claims/damages involving motor vehicles. District Consumer Disputes Redressal Commission-VII, Southwest Delhi Lack Of …

Ernakulam District Commission Holds Oriental Insurance Liable For Deficiency In Service Due To Non-Disclosure Of Policy Terms During The Signing Of The Contract
11 months, 3 weeks ago

Ernakulam District Commission Holds Oriental Insurance Liable For Deficiency In Service Due To Non-Disclosure Of Policy Terms During The Signing Of The Contract

Live Law  

The Ernakulam District Consumer Disputes Redressal Commission, headed by D.B. Upon visiting the insurer's office and providing details of pre-existing conditions, the complainant requested to port their existing policy, which the insurer agreed to do. Observations by the Commission The Commission observed that the insurer had failed to provide the complainant with the necessary terms and conditions of the policy …

Consumer Cases Monthly Digest: February 2024
1 year ago

Consumer Cases Monthly Digest: February 2024

Live Law  

Supreme Court Medical Negligence | Supreme Court Awards Rs 10 Lakh Compensation To Patient Who Developed Hoarseness In Voice After Trainee Gave Anaesthesia Case Title: J. DOUGLAS LUIZ THROUGH LEGAL REPRESENTATIVES VERSUS MANIPAL HOSPITAL | CIVIL APPEAL NO.1700 OF 2024 Citation: 2024 LiveLaw 134 The Supreme Court recently awarded Rs. District Consumer Disputes Redressal Commission-III, Hyderabad Hyderabad District Commission Holds …

Kerala consumer commission slams insurer, TPA for rejecting claim of elderly couple
1 year ago

Kerala consumer commission slams insurer, TPA for rejecting claim of elderly couple

New Indian Express  

THIRUVANANTHAPURAM: The State Consumer Disputes Redressal Commission has rapped Bajaj Allianz General Insurance Co. Ltd. and its Third Party Agent for rejecting the claims by an elderly couple. The commission severely criticised the TPA for going beyond its intended role and directly rejecting the claims. The Ernakulam District CDRC had earlier rejected the couple’s petition approving the respondents’ claim that …

Kerala consumer rights panel holds insurance company, bank accountable for medical claim denial
1 year, 1 month 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 …

Consumer Cases Weekly Round-Up; 22nd January To 4th February 2024
1 year, 1 month ago

Consumer Cases Weekly Round-Up; 22nd January To 4th February 2024

Live Law  

National Consumer Disputes Redressal Commission National Consumer Commission Holds Raheja Developers Limited for Deficiency in service The National Consumer Disputes Redressal Commission presided by Justice A.P. Liable For Unfair Trade Practice The District Consumer Disputes Redressal Commission, Kullu bench comprising Purender Vaidya and Pooja Gupta held HDFC Life Insurance Company liable for deficiency in services for falsely repudiating the claim. …

Annual Digest of Consumer Cases 2023: Part-IV
1 year, 2 months ago

Annual Digest of Consumer Cases 2023: Part-IV

Live Law  

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSIONS Manufacturers Intentionally Withholding Necessary Spare Parts Of Products Unfair Trade Practice: Kerala Consumer Forum Case Title: Cdr. Defective Hearing Aid Device, Lack Of Cooperation, Ernakulam District Commission Orders Dwani Hearing Air Centre To Refund Amount, Pay Compensation And Legal Costs Case: Krishnaraj S Vs Dwani Hearing Aid Centre The Ernakulam District Consumer Disputes Redressal Commission …

Consumer Cases Weekly Round-up: 27th November to 3rd December 2023
1 year, 3 months ago

Consumer Cases Weekly Round-up: 27th November to 3rd December 2023

Live Law  

Bombay High Court Electricity Connection On Particular Address Not Proof Of Ownership, Legality Of Construction: Bombay High Court Case Title: High Court On Its Own Motion v. State of Maharashtra through Principal Secretary & Ors., Suo Motu Writ Petition No.2/2023 A division bench of Justices Gautam S Patel and Kamal Khata of the Bombay High Court has held that an …

Consumer Cases Weekly Round-Up: 9th October 2023 to 15th October 2023
1 year, 5 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. …

Consumer Cases Monthly Round-Up: September 2023
1 year, 5 months ago

Consumer Cases Monthly Round-Up: September 2023

Live Law  

Ministry of Consumer Affairs, Food and Public Distribution NCDRC & Department Of Consumer Affairs Claims A Disposal Rate Of 188% In The Month Of August, 2023 In an official government notification issued on September 19th, the Ministry of Consumer Affairs, Food & Public Distribution has announced an outstanding achievement in resolving consumer cases by the National Consumer Disputes Redressal Commission. …

Consumer Case Weekly Round-Up: 18th September 2023 – 23rd September 2023
1 year, 5 months ago

Consumer Case Weekly Round-Up: 18th September 2023 – 23rd September 2023

Live Law  

Ministry of Consumer Affairs, Food and Public Distribution In an official government notification issued on September 19th, the Ministry of Consumer Affairs, Food & Public Distribution has announced an outstanding achievement in resolving consumer cases by the National Consumer Disputes Redressal Commission. Chandigarh District Consumer Disputes Redressal Commission-I Unilateral Payment Demands Amount to Unfair Trade Practice, Chandigarh District Commission Holds …

District Consumer Disputes Redressal Commission, Chennai (South) Holds Dealer Liable For Selling Defective Goods.
2 years, 1 month ago

District Consumer Disputes Redressal Commission, Chennai (South) Holds Dealer Liable For Selling Defective Goods.

Live Law  

The District Consumer Disputes Redressal Commission, Chennai comprising Mrs. B. Jijaa as President, Mr. T.R. The bench directed the Opposite Party to either replace the defective tiles of the Complainant’s house or to pay a sum of 4,18,080/- INR being the cost of the tiles and to pay a sum of 50,000/- INR as compensation for the deficiency in service …

[Employee's Compensation Act] Bar On Commissioner's Power To Conduct Enquiry Imposed By 2010 Amendment Act Is Prospective: Karnataka HC
2 years, 3 months ago

[Employee's Compensation Act] Bar On Commissioner's Power To Conduct Enquiry Imposed By 2010 Amendment Act Is Prospective: Karnataka HC

Live Law  

The Karnataka High Court has said the amendment brought to Section 20 of the Employee's Compensation Act, 1923, notified on 23.01.2014, which bars the Commissioner from conducting an inquiry/proceedings on the claims under the Act and confers the powers to the concerned courts, is not applicable to a case decided prior to issuing of the notification. A single judge bench …

Insurance firm directed to settle claims of patient
2 years, 10 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, …

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