Insurance firm told to pay ₹10k for deficiency in service

Ludhiana: The District Consumer Disputes Redressal Forum directed a general insurance company to pay a composite cost of Rs 10,000 to a complainant for deficiency in service for repudiating his claim. The commission comprising president Sanjeev Batra and members Monika Bhagat and Jaswinder Singh ordered the firm to settle the claim to Harvinder Singh of New Sant Fateh Singh Nagar, within 30 days from date of receipt of copy of the order.
Before going to Australia with his wife on April 26, 2018, the complainant had got his trip insured on April 13, 2018, with an assured sum of USD 50,000, along with coverage of medical expenses and USD 12,000 for any one illness, besides the coverage mentioned. During his trip, he fell ill and was diagnosed with ‘right upper lobe pneumonia with SIRS, acute kidney injury’, due to which he incurred medical expenses of $ 23,101.10. Later, he lodged a reimbursement claim, which was repudiated on September 6, 2018, owing to ‘non-disclosure of his pre-existing cardiac ailment’. After hearing both sides, the commission said the counsel for opposite parties had contended that Harvinder had responded to the query regarding pre-existing illness with ‘no’ so the repudiation was rightly invoked but, the proposal form was filled by an employee of the opposite parties. It held that perusal of copy shows that it bears the signature of the authorised signatory of the opposite parties.tnn