Bajaj Allianz General Insurance Company Ltd asked to pay ₹10,000 to Telangana senior citizen

A consumer forum directed Bajaj Allianz General Insurance Company Ltd to pay ₹ 10,000 to a senior citizen as compensation for ‘mental harassment’ owing to non-payment of insurance claim. The forum found that the company arbitrarily increased the sum insured from ₹ 1 lakh to ₹ 2 lakh and despite the complainant paying the enhanced premium, did not release the full amount when he was hospitalised.

The Hyderabad District Consumer Disputes Redressal Forum, Hyderabad – III was dealing with a complaint by N Anil Chandra Gowd (65), a resident of Jubilee Hills. The complainant stated that he was insured under the Health Guard Policy which was effective from September 2015 to September 2016. While he was insured for ₹ 1 lakh, at the time of renewal the sum insured was enhanced to ₹ 2 lakh for which he paid ₹ 24,214 as premium.

In January 2016, the complainant was diagnosed with renal failure and was admitted to a hospital. At the time of discharge, he was billed ₹ 2.20 lakh. However, the company agreed to pay only ₹ 1.20 lakh, despite him being insured for ₹ 2 lakh. For their part, the company stated that when bills were submitted, the payment was made per policy which is issued on the base principal policy. It also stated that the enhanced sum is supplementary and that the complainant’s claim is contrary to the policy stipulations.

The forum noted that the complainant said that he did not apply for enhancement of sum insured and that a fresh proposal form was not submitted. The company had in its renewal notice made the enhancements. It also noted that the company did not file copies of the proposal form for enhancement and that it ‘had failed to communicate the enhanced policy conditions’ in writing before renewal. It also stated that since the enhancement was done sans any notice, ‘the complainant certainly interpreted it to his advantage and is rightfully claiming the sum insured by way of the existing policy’.

“The repudiation on this basis amounts to deficiency in service and negligence and the point is answered in favour of the complainant,” the forum stated. Apart from ₹ 10,000 as compensation, the forum directed the company to pay ₹ 1 lakh and ₹ 5,000 as costs.

Source: The Hindu