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Insurance company penalised for denying full treatment claim to Chandigarh resident

State Consumer Commission enhances interest rate on claim amount from 6 to 9 per cent, directs insurance firm to pay Rs 20,000 compensation
Photo for representational purpose only. iStock
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For denying full claim of the treatment to a patient, the State Consumer Disputes Redressal Commission, Chandigarh, has directed ICICI Lombard General Insurance Company Limited to pay compensation of Rs 20,000 to a city resident.

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The commission has also directed the insurance company to pay balance claim amount of Rs 53,079 to the complainant, along with interest at 9 per cent per annum.

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The State Commission has passed the order on an appeal filed by Saroj Kumar Sharma, a resident of Chandigarh.

He challenged the order of the District Consumer Disputes Redressal Commission, Chandigarh, dated October 7, 2024.

Sharma said he approached the District Commission after the insurance company refused to pay the entire amount incurred for the treatment of his daughter-in-law.

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He said an amount of Rs 25,000 was approved by the insurance company and under compelling circumstances, the balance bill amount of Rs 53,079 was paid by him from his own pocket.

He said although District Commission partly allowed the complaint and directed the insurance company to pay Rs 53,079 incurred by him on the treatment of his daughter-in-law, yet, it erred in not awarding compensation for mental agony and harassment suffered by him.

After hearing the arguments, the State Commission directed the insurance company to pay the balance claim amount and Rs 20,000 as compensation, besides Rs 15,000 litigation to the complainant.

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