Insurance company asked to pay up

From The Times Of India

AHMEDABAD: The Consumer Disputes Redressal Forum, Ahmedabad District (Rural), has ordered United India Insurance Company Limited to pay $5041.65 as compensation to Smruti Bhaskar Patel for gross negligence, deficiency in service and unfair trade practices.

The forum ordered the insurance company to pay Smruti $5041.65 — $3632.15 plus $ 1409.50 with 9 per cent cumulative interest from the date of the complaint until recovery.

The amount will have to be paid in Indian rupees as per the exchange rate prevailing on the date of the complaint. The forum also ordered the company to pay her Rs. 10,000 for tension, hardship and inconvenience suffered by her. Smruti's complaint was filed by Consumer Education Research Society, Ahmedabad.

Smruti had paid a premium of Rs 3, 281 and taken an overseas mediclaim policy from United India Insurance on April 22, 2002, covering her during the period from April 27 to July 10, 2002. During her stay in the USA, Smruti suffered from acidity-related laryngeal lesion and was treated at the John Hopkins Hospital on July 1 and 2, 2002. She underwent a surgery on the second day.

Smruti paid US $ 3632.15 towards the charges for surgery and subsequent hospitalisation up to July 9, 2002. She submitted her claim form with original documents to Mercury International Assistance and Claims Ltd., the UK-based agent of United India Insurance. They returned some of the documents along with an undated letter and asked for a few other documents.

After futile correspondence, she sought the intervention of CERS, which in turn wrote to the chairman of the insurance company requesting an early settlement of the claim. Eventually, CERS and Smruti filed a complaint before the forum on May 30, 2003.