Inform within 24 hr rule by insurance cos harsh:Consumer Forum

Thane, Sep 20 (PTI) Thane Consumer Redressal Forum hasordered an insurance firm and a third party administrator(TPA) to jointly pay Rs 10,000 as compensation beside claimmoney to a man, observing that the rule to inform insurancefirm and TPA within 24 hours of hospitalisation is "harsh." Forum president N D Kadam and Sneha Mhatre in theirorder delivered on Monday directed United India InsuranceCompany and TPA, Medsave Healthcare Ltd to jointly pay theclaim amount and an additional of Rs 10,000 to Bhiwandiresident Ansari Hafij-ur-Rehman, towards his mental suffering. The complainant told the forum that he had got hishealth policy of Rs 1,72,000 renewed for a period fromSeptember 2009 to August, 2010. Rehman said he was unwell from July 23-28, 2010 andwas admitted to a hospital for treatment of hypertension anddiabetics type-2. Later on July 30, he again fell sick and wasreferred to Jupiter Hospital. The entire treatment cost him Rs1.54 lakh. Meanwhile, his family members informed the insurancefirm and the TPA on July 23 only. However, he was told next year in January by thecompany that his claim has been rejected on grounds that hedid not inform within 24 hours of the hospitalisation. Following the rejection, Rehman approached the forumand adduced all relevant documents. The forum observed that the complainant duly apprisedthe firm within 24 hours and thereby rejected insurance firm’sclaim. "If an insured sufferers sudden illness and isadmitted to hospital, then his relatives will first attend tohis treatment. At that time it is necessary to take intoaccount the mental situation of the relatives of the sickperson. At that time the condition laid by the insurancecompanies that they should be intimated within 24 hours of theadmission after getting the requisite documents is a harshone," the forum said. PTI CORR ARS DVBAS


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