Hyderabad Ombudsman Centre
Case No. : G 11.002.0114
Matam Subrahmanyam
Vs
New India Assurance Co.Ltd.
The complainant purchased an Overseas Mediclaim Policy from the insurer to cover himself and his wife on their visit to the USA in June 2005. He developed severe pain in the right ring finger during his stay abroad sometime in September 2005. He made several attempts to contact the insurers claims settling agent, M/s Coris International, whose number was printed on the policy document.
There was no response from the TPA either to his telephone calls or to the e-mails sent to them. He had no other alternative but to bear the terrible pain and postpone treatment till his return to India. Since he was put to tremendous inconvenience he was entitled to receive compensation of Rs. 5000/-. The complainant was treated shabbily by not only the TPA agent but also the Regional Office of the insurer.
The forum held that the complainant is justified in seeking some compensation for the expenses incurred in making phone calls, correspondence etc. The forum directed the insurers to pay an amount of Rs.1,000/-(Rupees one thousand only) to the complainant towards the same. The complaint is admitted.
