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Pay interest for mediclaim payout delay: Consumer body to firm

Pay interest for mediclaim payout delay: Consumer body to firm

Mumbai, Dec 31 (PTI) The Maharashtra State ConsumerDisputes Redressal Commission has ruled that mediclaim policyholders can claim interest if there is a delay in receiving reimbursement.The consumer panel's bench comprising president A PBhangale and member D R Shirasao was hearing a plea filed by awoman seeking interest on Rs 1.67 lakh reimbursement receivedby her for an ovarian surgery almost three years after filingclaim.In the order passed recently, the commission held thatthe woman was entitled to nine per cent interest on theamount.According to the consumer panel order, the woman hadavailed medical insurance from New India Assurance Co Ltd. During the subsistence of the insurance policy, she underwent an ovarian cystectomy in April 2011.After discharge, she made a claim for hospitalisationcharges which the insurance company repudiated.The woman then approached the insurance ombudsman, whoin October, 2013 directed the insurance company to settle theclaim of the woman.Thereafter, the company paid her the claimed amount ofRs 1.67 lakh.The woman, after encashing the amount, wrote a letterto the company seeking interest on the reimbursement due todelay.When the company refused to pay the interest amount,she filed a consumer complaint.The state consumer panel in its order noted that theinsurance ombudsman had only directed the insurance company togive the claim of the opponent."There is no reference in respect of giving intereston the amount of claim and costs and compensation to thecomplainant," the panel said."The opponent (insurance company) has not produced anydocument on record to show that the complainant had receivedthe amount of Rs 1,67,152 towards full and final satisfactionof her claim waiving her right to get interest on that amountalong with costs and compensation," the order said.The panel held that as the woman received themediclaim amount after around three years, she is entitled toget interest on it."She (complainant) was also required to approach theinsurance ombudsman for getting that claim from the opponentand hence, she is entitled to get compensation along withcosts of litigation," the panel held.The panel ordered the insurance company to pay thewoman interest at the rate of nine per cent from April 2011 toDecember 2013, adding that this amount will have to be paidwithin a period of two months."The opponent shall also pay a sum of Rs 25,000 ascompensation to the woman and Rs 5,000 towards litigationcost," the panel ordered. PTI SPBNM12311235 DPBDPB