AN Hariharan must have thought it was wise to apply for a medical insurance considering his declining age and health conditions. However, it turned out to be his biggest mistake ever after the insurance company stopped correspondence with him exactly when it needed to reimburse his medical expenses.
A senior citizen from Andheri got relief after the Mumbai Suburban District Consumer Dispute Redressal Forum ordered an insurance company and a charitable trust to not only pay the promised medical expense of Rs41,905 but also to pay Rs10,000 each for mental harassment as well as the cost of complaint.
AN Hariharan must have thought it was wise to apply for a medical insurance considering his declining age and health conditions.
However, it turned out to be his biggest mistake ever after the insurance company stopped correspondence with him exactly when it needed to reimburse his medical expenses.
Though, delayed by over a year, Hariharan finally managed to get his due through the consumer disputes redressal forum.
He had taken a cashless mediclaim policy from Winner Insurance Benefits Ltd through the Rukmini Charitable Trust for the period between January 20, 2008, and January 19, 2009.
During this period Hariharan went to Kerala and fell sick. He was admitted for 10 days at Bharat Hospital in Kottayam. Hariharan incurred a total expense of Rs65,175.
Thereafter, as per the rules, he sent all the concerned documents for reference to the charitable trust as well as the insurance company.
However, it was finally decided that the insurance company would reimburse only Rs41,905. Hariharan was convinced with the promised amount and thus submitted all the documents required.
However, the insurance agency kept on delaying the payment and finally he made an appeal in the consumer forum. Following the appeal, president of the forum JL Deshpande as well as members Deepa Bidnurkar and VG Joshi ordered the company and the trust that the senior citizen be compensated within six weeks.
The forum also ordered that if the said amount is not paid within the designated period, the insurance company will have to pay a fine of Rs500 per month.
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