Insurance company cannot reject Group Insurance mediclaim on ground of pre existing disease

Case of:- Ms.Megha Shah Vs The Oriental Insurance Co. Ltd. Complaint No. AHD-G-050-1718-0183-0184-0185-0186 Insurance Ombudsman Date of award: 21/06/2017 Policy Read more

Bombay high court declines relief on plea against mediclaim order




The Bombay high court recently declined urgent interim relief on a petition by a body of nursing homes/hospitals challenging an Insurance Regulatory and Development Authority circular that excludes hospitals having less than 15 beds from medical insurance. The HC said it would first like to know IRDA’s response. The new policy defining hospitals comes into effect from July 1.

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The Bombay High Court wants IRDA to set up Ombudsman for policy-holders

The Bombay High Court suggested the Insurance Regulation and Development Authority (IRDA) to set up an ombudsman to address insurance-related grievances of consumers. The suggestion was made by a division bench of Chief Justice Mohit Shah and Justice Anoop Mohta while hearing a public interest litigation (PIL) filed by a city-based social worker Gaurang Damani pointing out the hardships being faced by Medi-claim policy holders. Read more

CERS Makes Oriental Insurance Reimburse mediclaim worth Rs. 1.17 Lakh

The Consumer Disputes Redressal Forum, Ahmedabad (Additional), has directed Oriental Insurance Company Ltd. to pay its valid health insurance policyholder Chirag Sanghavi Rs. 1.17 lakh, part of it with interest, for the expenses incurred by him on his medical treatment. The amount includes compensation of Rs. 10,000 for his mental agony and Rs. 2,000 towards the litigation cost. Consumer Education & Research Society (CERS), a co-litigant with Sanghavi, was also awarded Rs. 2,000 towards cost. Read more

Penalise insurance firms for harassing customers

The Union finance ministry has been asked by a Delhi consumer forum to deal strictly with the private insurance firms and consider  cancelling their licences for harassing customers and illegally rejecting their claims. Read more