The Dharwad District Consumer Grievances Redressal Commission has penalized United India Insurance Company for rejecting a claim for eye treatment, imposing a fine of Rs 50,000 on the firm. The complainant, Ganesh Shetty, had taken out an insurance policy with the company and underwent cataract treatment at MM Joshi Eye Hospital in Dharwad, paying Rs 32,561. Despite having an active policy, the insurance company refused to reimburse the amount, prompting Shetty to file a complaint with the commission.
The commission, comprising Chairman Eshappa Bhute and member Vishalakshi Bolashetti, reviewed the complaint and found that Shetty had been a legitimate policyholder since 2010, continuously paying premiums and renewing his policy. The policy was active at the time of the treatment, and Shetty had submitted receipts for the treatment costs. The commission deemed the insurance company’s rejection of the claim as a “deficiency in service” under the Consumer Protection Act.
The commission ruled in favor of Shetty, ordering the insurance company to reimburse the treatment costs of Rs 32,561, along with 10% interest. Additionally, the company was ordered to pay compensation of Rs 50,000 for the inconvenience and mental distress caused, as well as Rs 10,000 towards legal costs. The commission’s decision highlights the importance of insurance companies fulfilling their obligations to policyholders and the consequences of failing to do so.
The case serves as a reminder to insurance companies to carefully review claims and provide fair reimbursement to policyholders. The commission’s ruling also underscores the importance of consumer protection laws in ensuring that individuals receive fair treatment and compensation for grievances. By imposing a significant penalty on the insurance company, the commission has sent a strong message about the need for companies to prioritize customer satisfaction and adherence to consumer protection laws.