Reliance Insurance to pay Rs 88K
New Delhi: The Reliance General Insurance Company Ltd has been ordered by a consumer forum to pay over Rs 88,000 to a mediclaim policy holders for its failure to facilitate cashless service to him for his daughter's surgery.
The New Delhi District Consumer Disputes Redressal Forum ordered payment of compensation saying the man was denied the service "when it was needed the most" and the firm treated his request for assurance for cashless facility as a claim for the same.
"In our view, Reliance General Insurance Company Ltd have clearly misdirected themselves in treating the request of complainant father, as request to allow claim. At that stage before admitting his daughter in the hospital, he only needed assurance that the cashless service can be availed. The firm failed to comfort him," said the forum's President C K Chaturvedi.
The consumer court's order came on a Dwarka resident, H K Choudhary's plea, which said his daughter was to be operated upon in Max Hospital on July 4, 2008 and he had requested the insurance firm to ensure cashless facilities.
He alleged despite informing the firm a month in advance, it kept making repeated enquiries and sought copies of various documents and even after providing all documents, it failed to facilitate cashless service and he had to pay Rs 38,800.
Choudhary had also alleged that during the pendency of the case he had submitted the claim of Rs 38,868 to the firm by e-mail, but it was yet to be settled.
The insurance firm had contended that it had made the repeated enquiries as it thought it was a request for allowing claim.
Rejecting the firm's contention, the forum directed it to "settle the claim within a month" and also awarded a "total compensation of Rs 50,000 to complainant for deficiency of service, when it was needed most."