Consumer court orders insurance company and bank to pay compensation for denying claim

KOCHI: The Ernakulam District Consumer Disputes Redressal Court has ordered the insurance company and the marketing intermediary bank to pay compensation for denying a health insurance claim.

The order was on a complaint filed by Ernakulam native and lawyer PR Milton and his wife Eva Milton. A bench of commission president DB Binu, members Vaikom Ramachandran and TN Sreevidya ordered the Cholamandalam Insurance Company and the bank to pay Rs 2,23,000.

On August 22, 2020, the complainant was admitted to a private hospital due to chest pain. The company offered cashless facility but the complainant had to pay bill. The insurance company told the court that it was only five months after the policy was taken and only after two years, the amount can be allocated for such diseases.

The court found that denying the amount on technicalities without considering the self-disclosure of the medical condition and transparent checks done at the time of taking the policy was unethical and deficient in service.

The court ordered that Rs 1,53,000 as medical expenses and Rs 70,000 as compensation for court costs should be paid to the complainants within one month.