A consumer forum here has turned down a man's plea seeking direction to an insurance company to clear his medical claim for hospitalisation, saying he had been admitted for less than 24 hours and that was not covered under the policy.
West Delhi District Consumer Forum dismissed the plea filed by Delhi resident Peeyush Aggarwal seeking Rs 5,241 from the New India Assurance Company Ltd as mediclaim.
The forum held that Aggarwal was discharged from the hospital on the same day that he met with an accident in 2009.
"If as per the terms and conditions of the policy, medical expenses are reimbursed only in case of minimum hospitalisation of 24 hours and complainant was not admitted in the hospital for (that duration), then where is the question of negligence in service.
"The claim was rightly repudiated as per the terms and conditions of the policy. There was no deficiency of service on the part of the (insurance company)," ruled the bench presided over by Bimla Makin and comprising members Urmila Gupta and Smita Shankar.
Aggarwal had told the forum that he had suffered injuries in the road accident in 2009 and was taken to a hospital in Gurgaon for treatment. He was given medication and discharged on the same date.
Thereafter, he claimed the money spent on medication from the insurance company.
In its reply before the forum, the insurance company said the claim was not admissible as per the policy since Aggarwal had not been admitted in hospital for a minimum period of 24 straight hours.
