Ref: E&R/LEGAL/ORIENTAL-58/PRESS/03/SAM-DG

CERS’ Claim on Oriental Insurance Settled

Consumer Education and Research Society (CERS), Ahmedabad, sent a legal notice on 3 December 2003 to the Oriental Insurance Company Limited, asking it to settle the Mediclaim of Mrs M.V.Joshi.

Mr Vikram N. Joshi and wife, Mrs M.V. Joshi, had taken a joint medical policy on 19 April 2001. The insurance cover was Rs 2 lakh each. Mrs Joshi had a haemorrhage on 4 December 2001 and was admitted to V.S.General Hospital. Later, she was shifted to the Karnavati Hospital, Ahmedabad.

Mr Joshi wrote to the insurance company on 5 December 2001 of his wife’s hospitalisation. Thereafter, Mr Joshi submitted medical bills and receipts for Rs 2,93,878.70 to the insurance company and claimed the amount. The company rejected the claim stating that the disease was pre-existing and the policy did not cover a pre-existing disease.

Mr Joshi, not satisfied with the decision of the insurance company, approached CERS for help on 14 September 2002. CERS wrote to the insurance company on 10 October 2002 and sent a reminder on 26 October 2002. As the matter was not settled even after nearly two years, CERS sent a legal notice to the company, as a result of which the claim was settled for Rs. 2 lakh to the satisfaction of the complainant.

Date : 30/12/2003
Place : Ahmedabad

D. Gupta
Associate Editor
INSIGHT - The Consumer Magazine

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CONSUMER EDUCATION AND RESEARCH SOCIETY
“Suraksha Sankool”, Thaltej, Sarkhej-Gandhinagar Highway,
Ahmedabad- 380 054 (INDIA)
Phone: 079-7489945-46 Fax: 079-7489947
E-mail: cerc@wilnetonline.net
Web Site: http://www.cercindia.org
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