A consumer forum bench, headed by its president K S Mohi, directed Oriental Insurance Company Limited to pay Rs 2,02,851, along with Rs 5,000 as compensation, to central Delhi-resident Yashvir Singh.
The forum also held that the repudiation of the claim of Singh was highly unjustified, unwarranted and unfounded, therefore, it amounted to deficiency in service.
"But once the claim is filed the insurance companies would immediately come out with all kind of defenses including the terms and conditions to thwart the legitimate claim of the hapless insured," the forum said.
On the insurance firm's submission that the claim was rejected relying on certain clauses on terms and conditions of the policy, the forum said that unless terms and condition have been supplied to the complainant before taking a policy, exclusion clause cannot be enforced.
On May 25, 2015 the mother of the complainant fell ill and was admitted to a hospital in Rajinder Nagar here for which the hospital raised a bill of Rs 2,02,851, but the insurance company rejected the claim.
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