Local redressal of group policy complaints tough

Ahmedabad: Is your company paying a huge premium towards group insurance policy for your Mediclaim? Then you may have to go to the National Consumer Dispute Redressal Commission (NCDRC) in New Delhi for your Mediclaim dispute as local consumer courts may not be able to entertain your complaints.A district consumer commission here has refused to entertain the complaints of an LIC employee on the grounds of pecuniary jurisdiction and said that they are maintainable only before the NCDRC. An LIC employee, Rajendra Darji, filed 10 complaints at the Consumer Dispute Redressal Commission, Ahmedabad (city), after claims ranging from Rs 4,000 to Rs 40,000 were rejected by the New India Assurance Co Ltd, from where the LIC had obtained the Group Mediclaim Insurance Master policy. The insurance company objected to the maintainability of the complaints before the district commission by citing provisions of Section 34 of the Consumer Protection Act; it says that a district commission does not have pecuniary jurisdiction to entertain the complaints.LIC paid Rs 97 crore in premium to the New India Assurance for the group policy. This is one of the eight different group policies by the LIC for which it paid Rs 378 crore premium with GST. The insurer in this case submitted that the value of goods or services paid as consideration by LIC, the policy holder, to the opponent (New India Assurance), exceeded way beyond the threshold limit of Rs 10 crore for invoking district commission’s jurisdiction. If the group policy premium is between Rs 1 crore and Rs 10 crore, then the jurisdiction of the state consumer commission is applicable. But since the premium paid by the LIC was more than Rs 10 crore, only NCDRC in New Delhi can entertain the complaint over refusal of claims.The district commission accepted the submission and cited NCDRC’s observations to reject the complaints. Mukesh Parikh of the All-India Consumer Protection and Action Committee, who too was part of the litigation, said that they will take up this issue before the higher forum. “Due to this provision, people covered by group insurance policies will find themselves helpless in getting their problems resolved at the local level. It is impossible for people to go to Delhi for disputes over small amounts. Many people must be facing this problem because huge firms pay crores in premium towards group insurance policies,” he explained.
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