DEAR VIEWERS,
Central District Consumer Disputes Redressal Forum has ordered The New India Assuance Co.Ltd., one of the biggest public sector general insurance companies, to pay around Rs.60,000/- as compensation to its policy holder SHIV KUMAR GUPTA.
Delhi-based Shiv Kumar Gupta holds a mediclaim policy from New India and he filed a claim for Rs.45,252/- towards medical expenses incurredfor his son. Mr. Gupta informed the Third Party Administrator (TPA) of New India Assurance and submitted the requisite documents to the TPA for claim processing. But the New India Assurance has closed the claim processing on the grounds that in spite of several reminders, the policy holder did not provide the doctor's prescription slip and IPD paper. However, neither the insurers nor the TPA could prove that they had sent out reminders to the policyholder. Therefore, the consumer court ruled the decision infavour of the claimant Shiv Kumar Gupta and asked New India to pay for the expenses incurred plus Rs.10,000/- as compensation against harassment and mental agony and Rs.5,000/- as litigation cost.
The authorised person of the forum, Mr. B.B. Chaudary said that the New India Assurance company closed the claim without any valid reason and caused harassment and mental agony to the complainant.
.... EDITOR
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