Haryana: Insurance firm directed to pay relief
Bajaj Allianz General Insurance Company Limited has been directed by the Jhajjar District Consumer Disputes Redressal Forum to pay a compensation of Rs 15,818 for deficiency in services to the complainant along with litigation costs of Rs 1,000.
THE JHAJJAR District Consumer Disputes Redressal Forum has directed Bajaj Allianz General Insurance Company Limited to pay a compensation of Rs 15,818 for deficiency in services to the complainant along with litigation costs of Rs 1,000. The forum, headed by Amar Nath Manocha, delivered its verdict on a complaint filed by Sanjay Sachdeva, a resident of Main Bazar, Bahadurgarh town here.
In his complaint, Sanjay had stated that he took a health insurance policy from the insurance company on December 18, 2008, and paid the installments of the policy regularly from his HDFC Bank account without any default.
On April 15, 2009, Sanjay himself got admitted at Maharaja Aggarsain Hospital, New Delhi, due to chest pain and was discharged on April 19. He had to spent Rs 17,878/- whereas he was entitled to an insurance cover of Rs 15,818 as per the policy but the amount was not paid by the company pleading that Sanjay had been suffering from hyper tension for the last six months before his admission in the hospital, said the complaint.
In its reply, the company submitted that the complainant is not entitled for any insurance cover as he concealed his true state of health at the time of taking the policy whereas he had been suffering from diabetes and hyper tension for the last six months; hence the company is not liable to pay the amount insured under the policy.
Thereafter, the complainant had placed a medical certificate issued by Dr Subhash Gupta, consultant cardiologist of Maharaja Aggarsain Hospital, New Delhi, wherein it was clarified that Sanjay had not any history of hyper tension and was admitted with complaint of chest pain.
After hearing the arguments and going through the documentary proofs produced by both the parties, the forum directed the Bajaj Allianz Insurance Company Limited to pay a compensation of Rs 15,818 along with litigation expenses of Rs 1000 to the complainant.
On April 15, 2009, Sanjay himself got admitted at Maharaja Aggarsain Hospital, New Delhi, due to chest pain and was discharged on April 19. He had to spent Rs 17,878/- whereas he was entitled to an insurance cover of Rs 15,818 as per the policy but the amount was not paid by the company pleading that Sanjay had been suffering from hyper tension for the last six months before his admission in the hospital, said the complaint.
In its reply, the company submitted that the complainant is not entitled for any insurance cover as he concealed his true state of health at the time of taking the policy whereas he had been suffering from diabetes and hyper tension for the last six months; hence the company is not liable to pay the amount insured under the policy.
Thereafter, the complainant had placed a medical certificate issued by Dr Subhash Gupta, consultant cardiologist of Maharaja Aggarsain Hospital, New Delhi, wherein it was clarified that Sanjay had not any history of hyper tension and was admitted with complaint of chest pain.
After hearing the arguments and going through the documentary proofs produced by both the parties, the forum directed the Bajaj Allianz Insurance Company Limited to pay a compensation of Rs 15,818 along with litigation expenses of Rs 1000 to the complainant.
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