Ahmedabad Ombudsman Centre
Case No. NIC / 1 / 100
Shri N. S. Patel
Vs.
National Insurance Company Ltd.
Complainant met with an accident. Claim towards hospitalisation and medical expenses was lodged with the Respondent and also with TPA. TPA settled the claim of medical part fully, but Respondent, as PA part of Claim, paid 6 weeks TTD instead of 8 weeks recommended by the Treating Doctor. Complainant submitted during hearing that he has received the balance amount and his intention of appearing in the Hearing is to make the Respondent conscious towards the interest of customers and tone up their administration to avoid unnecessary delay and harassment as happened in his case. Respondent admitted the inordinate delay in making the balance payment to the Complainant. Complainant demanded no other monetary benefit. Therefore, an order is passed to the effect for closing “the case with a message to the Respondent’s different level of offices for more sensitive to the needs of the Policyholders by effecting timely settlement of claim.
