PER SHRI. 

1)       

2)       for himself and his family members andsince then he was paying the premium regularly to the Opposite Party.  .35 as per the final bill of hospital and other expenses to TPA Vipul Med Corp. Pvt. Ltd. with all necessary documents on 25/08/2010.          

3)          .3 & 5.4 which was not complied by the Complainant and hence, the claim was rejected.  written statement).  .35 for hospitalization expenses and deny the statement made by the Complainant in complaint. Hence, the Opposite Party prayed that this complaint be rejected and compensatory cost may be granted to the Opposite Party.

4)                 

5)       .3 & 5.4 of Mediclaim Policy and he has also not complied the query made by the Opposite Party.  

6)            Considering the aforesaid directions given in the circular by the Opposite Party 

7)       Oriental Insurance Co. Ltd.

Before parting with this case we would like to observe that the insurance companies in genuine and bona fide claims of the insurers should not adopt the attitude of avoiding payments on one pretext or the other. This attitude puts a serious question mark on their credibility and trustworthiness of the insurance companies. 

            The Complainant is also entitled for cost of this proceeding to the tune of Rs.5,000/-. 

O R D E R

i.                   Complaint No.41/2012 is partly allowed against the Opposite Party.

ii.                The Opposite Party is directed to pay an amount of Rs.35,627/- (Rs. Thirty Five Thousand Six Hundred Twenty Seven Only) together with interest @ 9% p.a. from the date of lodging of claim i.e. 25/08/2010 till it’s realization to the Complainant.

iii.              The Opposite Party is also directed to pay an amount of Rs.5,000/- 

iv.              The Opposite Party shall comply with the aforesaid order within one month from the date of service of this order. 

v.                 Certified copies of this order be furnished to the parties.