After a health insurance firm failed to provide claim to a patient, Consumer Dispute Redressal Forum here directed the firm to provide a compensation of Rs 4.81 lakh to a local resident. The forum has also imposed penalty of Rs 10,000 for causing mental agony to the resident. Vijay Devkar, 35-year-old resident of Vekantesh Vihar in Chhota Bangarda, had insurance for his father Bhagwandas Devkar.
Bhagwandas was diagnosed with sepsis with multiple organ failure (bilateral pneumonia/ acute renal failure/ multi organ failure/ sepsis/ post of jejunal resection) in 2016. He underwent a surgery for it at a private hospital. When the plaintiff applied for the claim, he was given merely Rs 15,000 as a compensation for the treatment though the bill amounted to Rs 4.81 lakh. Bhagwandas passed away due ill-health on November 4, 2016.
According to the petition submitted by Vijay Devkar, he has been a health insurance policyholder for past eight years in 2016. Based on documents submitted, the forum chairman Om Prakash Sharma and member Atul Jain observed that insurance firms denying claims proves negligence and deficiency in service. The forum directed insurance firm to provide a compensation of Rs 4.81 lakh to Vijay Devkar.
