Delhi district consumer redressal forum has directed ICICI Lombard general insurance to pay compensation of Rs 40,000 and litigation cost of Rs 10,000 to Satya Prakash for harassing him by not providing him cashless medical facility.
Complainant Satya Prakash has bought a health insurance from ICICI Lombard for two years and during this period he under went a treatment for a heart ailment at Sir Ganga Ram hospital.
Despite acting as per the terms of the policy for availing the cashless facility he was denied the cashless facility by the company.
In its reply company said that request of cashless facility was never denied and case went into closure as no reply was received to its queries either from hospital or Satya Prakash.
However, forum said that hospital provided all necessary information to the insurance company to make available facility to the complainant so he could be admitted to the hospital for his heart ailment.
Forum also said that it appears that company has decided to remain silent about the request of cashless facility hence; it amounts to denial of cashless facility that even without any valid reason. Therefore, this considered as the deficiency of service on the part of the insurance company.
Complainant Satya Prakash has bought a health insurance from ICICI Lombard for two years and during this period he under went a treatment for a heart ailment at Sir Ganga Ram hospital.
Despite acting as per the terms of the policy for availing the cashless facility he was denied the cashless facility by the company.
In its reply company said that request of cashless facility was never denied and case went into closure as no reply was received to its queries either from hospital or Satya Prakash.
However, forum said that hospital provided all necessary information to the insurance company to make available facility to the complainant so he could be admitted to the hospital for his heart ailment.
Forum also said that it appears that company has decided to remain silent about the request of cashless facility hence; it amounts to denial of cashless facility that even without any valid reason. Therefore, this considered as the deficiency of service on the part of the insurance company.
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