Thane district's consumer dispute redressal forum on Thursday held Reliance General Insurance company guilty of providing faulty services to one of its consumers after the firm repudiated a mediclaim policy claim. The forum has directed the firm to repay medical expenses of Rs3 lakh to the consumer along with Rs1 lakh towards compensation and litigation cost.
The complainant, Arvindbhai Jain, a Bhayander resident, on March 26, 2009, had bought a mediclaim policy from the firm, which was active till March 25, 2010. In that period, Jain was diagnosed with a heart ailment for which doctors advised him to undergo a bypass surgery, which he did.
Jain, in his complaint, claimed that after he completed his treatment, he approached the firm and sought reimbursement for his medical bills. The firm, however, repudiated the claim.
Aggrieved by the firm's negligent attitude, Jain, in November 2010, approached the consumer forum. The forum, after going through the complaint, asked the firm to file its say to which the firm claimed the complainant, while purchasing the policy, had failed to mention important details about his health and, hence, his claim was rejected.
The forum went through the evidence and held that while it was true that the complainant had failed to inform the firm important details about his health, the firm, in this case, with Jain submitting original medical bills, should have repaid the insurance claim and, hence, penalised it.