Pay Rs 7,000 for rejecting claim, consumer court tells insurance firm

MUMBAI: A Central Mumbai consumer disputes redressal forum on Friday directed New India Assurance Company Ltd to pay Rs 7,000 as compensation for mental agony to a medical policy holder, Bugwadia Phiroj.

Phiroj, a senior citizen, was admitted to a hospital in 2012 for a urinary tract infection. After discharge, he sent the bills for claim but despite follow-ups, the authorized TPA, Vipul Medcorp, and K U Sampath, the development officer at New India Assurance, did not revert till January 2013. Phiroj was told the file had been dumped in the godown without processing and a discharge voucher for Rs 41,000 was sent by courier.

Bugwadia said there were deductions in the money and demanded Rs 63,000. The forum found that despite having paid his premiums in time and filing a proper claim with verified bills, his claim was wrongly denied causing him "mental agony" for which he must be compensated.

The forum ordered New India Assurance and TPA to pay Rs 63,000 with interest of 9% per annum from September 2013 and Rs 5,000 as costs in a month.

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