Chennai Ombudsman Centre
Case No. : 11.02.1059/2006-2007
Shri. S. Swaminathan
Vs
The New India Assurance Co. Ltd
The complainant represented that he and his spouse were covered under Overseas Mediclaim Policy with New India Assurance Co. Ltd, from 17.09.2005 to 14.01.2006, for 120 days. He left for the USA on 17.09.2005 and returned to India on 16.12.2005, prior to the expiry of the policy period, hence he requested the Insurer to refund the balance premium amount for the unexpired period. However, the Insurer rejected his request on the ground that the premium was collected for the Trip band of 91-120 days, the actual stay abroad was 91 days which falls within the said trip band on which premium was collected.
The insurer contended that the total stay of the insured was 91 days and the premium had been collected on a trip band basis for the band 91-120 days. Since the insured returned from the US after a stay of 91 days, which falls within the trip band period, the insurer expressed their inability to refund the premium.
The forum pointed out that though the insured has fulfilled the general condition 1(iii) of the policy, the insured has traveled for 91 days, which falls within the trip band period i.e 91-120. Under the circumstances, as per policy provisions, the insured incurs the same premium. So the insurer need not refund the premium. Hence, this forum dismissed the complaint.
