Insurance firm rapped for refund delay

KOLKATA: Sridhar Shingee took out amediclaim policy with an insurance major, hoping he had bought himself peace ofmind. He was wrong. In 1994, he developed problems in his kidneys and went infor a transplantation at Madras Institute of Nephrology. Shingee washanded a whopping hospital bill of Rs 1,22,787. He claimed a reimbursement ofthis amount from his insurers, and completed the necessaryformalities.He had informed the insurance company before and afterthe operation. Despite several requests, the insurance company neither acceptedthe claim nor rejected it.In 1997, Shingee filed a complaint withCalcutta District Consumer Disputes Redressal Forum unit I seeking adequatecompensation. In an order passed on February 18, 1998, the forum directed theinsurance company to pay the complainant a full refund of the medical expensesamounting to Rs 1,22,787, borne by him.Strangely, both thecomplainant and the insurance company appealed against this order to the stateconsumer disputes redressal commission.The consumer felt he had notreceived adequate compensation while the insurance company pointed out that theyhad not had been given an adequate opportunity of being heard. Thestate commission, in an order passed on October 11, 2001, sent the case back toCDF-I for fresh trial. A three-member forum headed by president P.N. Bhadury inan order passed on March 30, 2005, directed the insurance company to pay theconsumer a full refund of Rs 1,22,787.They were also asked to payShingee Rs 10,000 as compensation for causing him needless harassment and afurther amount of Rs 1,000 as costs.In the opinion of the court, theinsurance company had put off the matter far too long. This was a clear case ofdeficiency in service on part of the insurance company and violation of theprovisions of Consumer Protection Act, 1986.