[Resolved]  The New India Assurance Co. Ltd. — Late payment of mediclaim & unwarranted deduction from claim amount.More over award of ombudsman not implemented.

BHUPENDRA C SHAH
M-5-4-28, Shastrinagar
Naranpura
AHMEDABAD - 380063
Date: 26/12/2008
Phone:[protected]R)
[protected](M)
REGD. A. D.[protected]O)
District Consumer Disputes Redressal Forum
Behind Bhagvati Complex
Mahalaxmi, Paldi
AHMEDABAD-380007

Respected Sir,
Re.: Grievance against
(1) The New India Assurance Co. Ltd (Sri Sheikh, Dy. Manager
Dr. J H Rushat, Chief Manager, Sri H K Vajpaee, Representative)
For Part Payment of Mediclaim & non payment of Interest for delayed
Payment. Policy No 120700/34/08/12/000000/49 of year 2008-09
(2) Insurance Ombudsman (Respected Sri Amitabh)
for making mockery of justice in Hearing and non compliance to my
grievance letters

Sir, I beg your permission to represent my first grievance against The New India Assurance Co. Ltd, Laldarwaja, Ahmedabad - 380001 and second grievance against Insurance Ombudsman through you Office.

(A) Grievance against The New India Assurance Co. Ltd, Laldarwaja, Ahmedabad - 380001
I am a member of LIC MEDICLAIM GROUP INSURANCE POLICY With The New India Assurance Co. Ltd. Premium is deducted from my salary and paid to Insurance Co. through my
Employer.
On12/08/2008 I submitted Claim Forms for Rs. 74799/- with relevant documents but only.
on 23/10/2008 I received discharge voucher for Rs. 73919/- without assigning any reason for part reimbursement as against claim of Rs. 74799/-. I submitted the same voucher duly signed and completed on 23/10/2008 but I received cheque of Rs.73919/-.only on 31/10/2008 at 5.25 p.m. (after office hours)
Thus, I received only part reimbursement which is short by Rs.880/- than claim amount of Rs. 74799/- after inordinate delay of 81 days without penal interest @ 18% p.a.
More over on 10/03/2009 I had submitted my letter showing conditional acceptance of the AWARD for payment of late fee (Interest) issued by Insurance Ombudsman to following address. Neither received payment of interest nor any reply from them:
Chief Regional Manager,
New India Assurance Co. Ltd,
Ahmedabad Regional Office,
Popular House, 5th Floor, Ashram Road
Ahmedabad-380009

Kindly resolve my grievance as detailed above and mentioned in Page No (2)


……………….. (2)
(2)

(1) Reply to my communications pertaining to mediclaim which includes

(i)….E-mail dated 2/11/2008 sent to e-mail [protected]@wilnetonline.net (Sri Sheikh)
(ii)….E-mail dated 11/11/2008 sent to e-mail id jh.[protected]@newindia.co.in (Dr. J H Rushat)
(iii)… Grievance letter dated 12/11/2008 sent by Regd. A D Post to Sri N C Parmar, Manager
(Now Sri Sheikh, Dy. Manager)
(iv)… Regd. Letter dated 12/11/2008 to Dr. J H Rushat, Chief Manager, Handling Grievance
Cell at H O, The New India Assurance Co. Ltd, 87. M G Road, Fort, Mumbai-400001.
(v)… Letter of award submitted on 10/03/2009 to Chief Regional Manager.

(2) Immediate reimbursement of Rs 880/- being short reimbursement along with penal interest
@ 18% p.a. from 12/08/2008 to date of reimbursement of Rs.880/-

(3) Immediate payment of penal interest of Rs.2953/- @ 18 % p.a. for 81 days on Rs.73919/-

(4) Immediate payment of Rs.5000/- towards the cost of case being taken up against The
New India Assurance Co. Ltd .which includes expenses towards Postage, drafting, Printing and Mental Stress/Harassment I am suffering since 12/08/2008 for non compliance of my grievance.

Sir, kindly make use of your good office and arrange to resolve my grievances at the earliest and arrange for payment as detailed below:

(2) SHORTFALL IN PAYMENT[protected][protected]-- RS. 880/-
(3) INTEREST FOR LATE PAYMENT OF RS.73919/[protected] RS.2953/-
(4) COST OF CASE.TAKEN UP[protected][protected]--RS.5000/-
TOTAL AMOUNT[protected][protected][protected]RS.8833/-

(B) Grievance against Insurance Ombudsman (Respected Sri Amitabh)
As per Provisions of IRDA Guidelines I Approached Insurance Ombudsman on 29/12/2008
for redressal of Grievance but the hearing was conducted with bias back ground. Justice was not
done to me. Award (Xerox Copy Enclosed) was given only for payment of interest for late payment but without mentioning rate of interest and period. I had been informed to approach other forum/court. Respected Sri Amitabh, Insurance ombudsman also not responded so far to my letters dated 04/02/2009 and 09/03/2009 (Xerox Copies enclosed for ref.).

Thanking you in anticipation of your kind co-operation in the matter.

Encl.: (1) Claim Form dated 12/8/08 (Two Sides) YOURS SINCERELY,
(2) Voucher F/W letter dated 24/10/2008
(3) E-mail dated 2/11/2008 to Dy. Manager
(4) E-mail dated 11/11/2008 to Chief Manager (B C SHAH)
(5) Grievance letter dated 12/11/2008 to Dy. Manager ASSTT. SECRETARY
(6) Grievance letter dated 12/11/2008 to Chief Manager AUDIT CENTRE, AHMEDABAD
(7) Letter of award submitted on 10/03/2009 to Chief Regional Manager
(8) Letter dated 04/02/2009 to Insurance ombudsman
(9) Letter dated 09/03/2009 to Insurance ombudsman