Oriental Insurance Company held deficient in service for denying mediclaim | chandigarh | Hindustan Times
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Oriental Insurance Company held deficient in service for denying mediclaim

Holding Oriental Insurance Company Limited deficient in service for failing to settle a mediclaim policy, district consumer disputes redressal forum, Chandigarh, has directed it to pay Rs 10,000 as compensation to a Sector 46 resident.

chandigarh Updated: Nov 08, 2013 21:59 IST
HT Correspondent

Holding Oriental Insurance Company Limited deficient in service for failing to settle a mediclaim policy, district consumer disputes redressal forum, Chandigarh, has directed it to pay Rs 10,000 as compensation to a Sector 46 resident.


Apart from this, the company will also have to reimburse Rs 30,300 spent on the treatment along with paying Rs 5,000 as the cost of litigation.

Ritu Gagneja, in her complaint had said that she got a joint mediclaim policy with her husband in March 2011 for a sum of Rs 3 lakh and paid premium of Rs 8,339.

She claimed that in September 2011, she underwent a surgery for gall bladder stones and spent Rs 30,300 on the treatment, following which a claim was lodged with the insurance company for reimbursement, but the same has been kept pending by the insurance company.

Meanwhile, the firm said that the claim was repudiated as her disease falls under the exclusion clause for initial two years of issuing the policy and the information regarding the same was given to her in November 2011.

The forum in its order dated November 6, held: “Judged from every angle, the insurance company has wrongly repudiated/rejected the rightful mediclaim filed by the complainant. The deficiency in service is writ large.”