Health insurance frm asked to pay Rs 3 lk to claimant

Health insurance frm asked to pay Rs 3 lk to claimant
Health insurance frm asked to pay Rs 3 lk to claimant

A consumer court of Thane has ordered a health insurance company to pay Rs 3 lakhs to a claimant as it failed to prove that his wife was suffering from a disease prior to issuance of the policy.

Complainant Dilip Mohite informed the Thane District Consumer Redressal Forum that he had taken a floater insurance for Rs 3 lakh for his family members, including wife and two children, from Star Health and Allied Insurance Company.

In June 2012, his wife fell ill and had to undergo an angiography and angioplasty, for which he had lodged a claim of Rs 3 lakh with the insurance company.

However, the insurance firm rejected the claim stating that it was a pre-existing disease which Mohite had concealed at the time of taking the policy, and thus rejected it.

Mohite then approached the forum seeking a claim of Rs 3 lakh and Rs 50,000 as compensation.

The insurance firm said it was observed that there were 90 per cent blockages (in heart) detected on the patient, which meant that it had taken a long time to develop and can be treated as pre-existing, and hence it rejected the claim.

Forum president Shena Mhatre and members Madhuri Vishwarupe and ND Kadam gave the definition provided by a court ruling in a case that “pre-existing disease is one for which the insured should have undergone hospitalisation or undergone long treatment or operation.”

The insurance firm had not produced any proof of the claimant undergoing any treatment of heart ailment prior to the present illness, and hence the contention that the disease was pre-existing cannot be accepted, the forum noted.

As there is no proof whatsoever of the claimant having been treated or admitted for any heart ailment prior to the taking of the policy, the reasons given by the insurance company cannot be accepted, it observed.

Thus, the forum last week ordered the insurance company to settle the entire claim amount of Rs 3 lakh to the complainant along with a compensation of Rs 10,000.

( Source – PTI )

CWG scam: Court grants bail to a firm’s official

The Delhi High Court Tuesday granted bail to Binu Nanu, an official of a private firm who was held in judicial custody for his involvement in the Rs.600-crore overlays contract for the Commonwealth Games last year.

Justice Ajit Bharihoke allowed the bail application of Nanu on a personal bond of Rs.50,000 along with two sureties of like amount. He was arrested Jan 18.

“Binu Nanu is granted bail as he has completed 57 days in judicial custody,” the judge said.

The court asked Nanu to surrender his passport to the trial court and to join the investigation whenever the Central Bureau of Investigation (CBI) called him. It also told him not to try and tamper with evidence.

The court said he was released on bail because CBI officials submitted that they were not filing a charge sheet against him within the stipulated 60 days from the date of his arrest.

The CBI officials said they did not require Nanu’s custody any more because they had already investigated into the matter and questioned his employees, said Justice Bharihoke.

Nanu, the director of event management company GL Events-Meroform, said in the bail plea that he was remanded to judicial custody by a lower court on the conclusion of his four-day custodial interrogation by the CBI.

The CBI Jan 12 searched the offices and residences of Nanu and many others after it registered a case in the alleged overlays scam.

“Nanu’s wife Roopana is also one of his associates in the business,” the agency said.

The case, the fourth in connection with the Games, was registered against former Games Organising Committee director general V.K. Verma.

The CBI alleged that Verma and others entered into a “criminal conspiracy” with managing directors and directors of private companies in the award of contracts for overlays for different venues of the Games at “exorbitant rates”.

The overlays contracts are also under the scanner of the Income Tax department and the Enforcement Directorate.

The overlays included supply of tents, pre-fabricated units, portable toilets, containers, security fences, furniture, public display LED boards, floor finishes, material handling equipment, gensets, cabling, air-conditioners, lighting, civil construction and exercise equipment.