Face2News/Abohar.
Permanent Lok Adalat Fazilka, accepting the prayer of Inder Mohan Garg, resident of Gobind Nagari, has ordered the insurer United India Insurance Company Limited to pay a client the amount spent on his treatment in two hospitals.
The above orders were passed by the bench of Chairman Jitender Pal Singh Wahniwal with members Veerpal Kaur and Mukesh Kumar Bansal while disposing off the complaints filed by Garg in 2018. The complainant was represented by S.P. Khariwal while the counsel for the insurance company gave his arguments in the hearing.
(SUBHEAD)Garg said through his counsel that he had taken a health insurance policy of Rs 3 lakh from January 2, 2015 to January 1, 2016. He took treatment at Ganga Ram Bansal Super Specialty Hospital and later was treated at Dayanand Medical College and Hospital, Ludhiana. On March 19, 2016, he requested the insurance company to pay the treatment cost of Rs. 1 lakh 9 thousand and in the second case Rs. 32 thousand 855. But his requests were turned down saying that he had been Alcoholic for the last 20 years. Hence not eligible for insurance amount.
The court observed in its Award that the claim was made on behalf of the company about the complainant being an Alcoholic on the basis of a Doctor’s opinion but the company failed to produce the certificate during the hearing. No clinical test report was also presented in this regard. The company also failed to establish that the policyholder was unwell for a long period of time. Therefore, Rs 32 thousand 855 spent in Ganga Ram Bansal Super Specialty Hospital Sriganganagar and Rs 1 lakh 9 thousand spent in Ludhiana should be paid along with 9 percent interest.
