ICICI fined Rs 50K for no cashless service

ICICI Lombard General Insurance Company has been directed by a Delhi consumer forum to pay Rs 50,000 as compensation to one of its policy holders for harassing him by not providing cashless medical facility.

The District Consumer Disputes Redressal Forum held the company "deficient in service" for not providing cashless facility and remaining silent on the request of the consumer who provided all necessary information.

"The deficiency in service on the part of the insurance company is its non-action on the request of the complainant to provide him cashless facility for his medical treatment," the forum presided over by B B Chaudhary said.

The complainant Satya Prakash, had purchased a health insurance policy for two years, during which he underwent treatment at Sir Ganga Ram Hospital for a heart problem.

He said despite acting as per the terms of the policy for availing cashless facility, he was denied the same.

The company, in its reply, contended that cashless request was never denied and the case went into closure as no reply was received to its queries from the hospital or Prakash.

The forum, however, said, "The hospital provided all necessary information to the insurance company to make available the facilities to the complainant so he could be admitted in the hospital for his heart problem."

"It appears that the insurance company decided to remain silent about the request of extension of cashless facility. By implication, it amounts to denial of cashless facility and that too without any valid reason," it said.

"We allow the complaint with directions to the insurance company to pay the complainant a sum of Rs 40,000 for causing harassment and a sum of Rs 10,000 as cost of litigation," it said.

Source: Financial Express