Bajaj Alliance General Insurance to foot bills of woman injured in US

NEW DELHI: New Delhi District consumer forum has asked Bajaj Alliance General Insurance to foot the medical bills of a woman who had suffered an injury in the US after taking a foreign travel mediclaim policy.
The forum asked the insurance company to make the payment of $1529.15 to American Medical Response and a payment of $7285.97 to Santa Clara Valley Medical Centre "in case the payment hasn't been made already'' and also awarded a compensation of Rs 1 lakh to the complainant Rajesh Aggarwal.
Rajesh, a resident of Delhi had taken Travel Elite Silver Insurance on March 13 2007 and paid a premium of Rs 7,820 to Bajaj Alliance before she travelled abroad to visit her family members. The policy was valid up to August 2 2007 or her date of return whichever was earlier. As per terms of the policy, she was insured for medical expenses to the tune of $50000. On May 8 2007 in the evening, while staying at her relative's place in the US, Rajesh slipped in the kitchen and sustained an abdominal injury. Next morning she was shifted to the Santa Clara Valley Medical Centre. American Medical Response billed her $1529.15 for shifting her to the centre. At Santa Clara Valley Medical Centre, a series of tests were conducted and the patient was diagnosed with abdominal wall contusion and chest wall contusion as a result of accidental fall. She was treated and the bill came to $7285.97. The insurance company however took the stand that the patient had a history of illness and dizzy spells because of stress, refusing to foot the bills.
Dismissing this, consumer forum president, K K Chopra noted that,"the doctor had diagnosed the patient had an abdominal wall contusion and chest wall contusion as a result of an accidental fall. And hence the complainant was not suffering from pre-existing disease.''