Insurer ordered to pay Rs 52 lakh for rejecting medi-claim

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The  Maharashtra Consumer Redressal Commission has directed New India Assurance Company to pay Rs 52.07 lakh to a city resident for repudiating her foreign medical claim and deficiency in service.

Presiding member P N Kashalkar ordered the insurance company to pay this amount along with interest at the rate of 7 per cent per annum from the date of rejection of the claim, October 20, 2010, till actual realisation, besides Rs 20,000 as costs incurred by complainant Nina Sudhir Thackersey.

The complainant had taken an Overseas Mediclaim Policy from New India Assurance Company for USD 1,00,000 towards illness and treatment for accident for the period April 26, 2010 to April 25, 2011.

While on her trip to Zurich in Switzerland on May 9, 2010 she complained of constant chest pain and upper abdominal pain, following which she was admitted at Klinik Hirslanden in Zurich.At the clinic, Nina was examined by Dr Med. A Muller, Dr Henry Perschak and Dr Stefano Tresch and was subsequently admitted in the intensive care unit where she was administered dialysis. Nina was indoor patient at the clinic for 19 days, and was discharged on May 28, 2010.

Nina was asked to stay back for four days and called for re-consultation on June 4, 2010. On June 1, she was examined again by Dr Tresch who advised her by issuing a certificate that she should go back to India accompanied by a doctor. She returned to India on June 2, along with her husband and an Indian doctor.

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