The National Consumer Disputes Redressal Commission (NCDRC) today directed an insurance firm to re-process the mediclaim of a woman on the ground that she was not suffering from any pre-existing diseases.
It also imposed a cost of Rs 15,000 on the New India Insurance Corporation Limited (NIICL) to be paid to the petitioner, the husband of the woman, for harassment that he underwent with respect to the mediclaim of his spouse.
"We conclude that repudiation of mediclaim on the grounds of pre-existing diseases by the insurance company is without just cause. It is, therefore, directed to re-process the medical claim of the petitioner's wife," the Commission, comprising President Justice A Bhan and Member V Rai, said.
The Commission passed the order on a petition of P S Chetty, the husband of the spouse, challenging the lower fora's decision of dismissing his complaint against the insurance company's rejection of claim on the ground of pre-existing diseases.
Chetty had sought reimbursement of medical expenses from the insurance company which had denied her mediclaim despite being covered under an health insurance policy.
The Commission said the company had no ground for rejecting the claim as she was covered under the new policy with effect from April 1, 2000 and hospitalisation occurred after the stipulated period of 30 days of issuance of the policy.
Earlier, the Chittoor District Forum and Andhra Pradesh State Consumer Commission had dismissed the petitioner's complaint.
