Cashless treatment denial? Insurance co to pay damages

An insurance company has been directed by a consumer court to pay a compensation of Rs 7,000 for failing to settle a medical claim of a patient despite receiving all the necessary documents from him.

The East Delhi District Consumer Forum directed the Reliance General Insurance Company Limited to reimburse medical expenses of Rs 90,688 to the complainant, who had taken the cashless scheme from it.

The insurance company had alleged that despite repeated reminders, the complainant had not submitted any necessary documents for the purpose of settling the claim.

"The objection taken by the insurance company in not settling the claim of the complainant can not be sustained," the forum bench, comprising President U C Tiwari and Members T Vijayan and M Saxena, said.

"The objection raised by the company in claiming that the dispute can only be decided in the civil court after leading of evidence, is without merit and appears to be aimed to frustrate his claims," the forum said.

Mahender Kumar, the complainant, had underwent medical treatment from Ram Singh Hospital and St Stephens hospital in 2008 but he was denied cashless hospitalisation by the insurance company.

Kumar moved to the consumer court seeking directions to the company to reimburse his medical expenses, besides paying a compensation.