The East District Consumer Disputes Redressal Forum made this recommendation while ordering Apollo Munich Health Insurance Co Ltd to pay over Rs 1.8 lakh to a policy holder for not reimbursing his treatment expenses and illegally cancelling his insurance cover after he submitted his claim.
"Private insurance firms are resorting to such acts just to save the amount which they are legally bound to reimburse to policy holders. This needs to be dealt with by appropriate authorities and license of such companies may be considered to be cancelled," said the forum's bench presided by N A Zaidi.
"Let copy of this order be forwarded to Secretary (Finance), Ministry of Finance, Govt. Of India for perusal and strict action," it added.
The forum gave this order holding that the insurance firm "harassed and traumatised" the insured by their "unlawful action" and "illegal methods" to deny his rightful claim under the policy.
"Complainant (policy holder) of this case has been harassed, traumatised by the opposite party (Apollo Munich) by their unlawful action and illegal methods to deny rightful claim under the policy," the bench said, directing the insurance firm to reimburse the medical expenses of over Rs 1.4 lakh incurred by policy holder. It also asked to pay him Rs 40,000 as compensation.
The forum also comprising member T Vijayan observed that the policy holder had already been admitted for treatment prior to cancellation of his policy and refund of the premium and as he had already submitted his claim such termination "shall be deemed to be a device to deny his rightful claim." (More)
