Chandigarh

DF-II

CC/498/2018

Anju Aggarwal - Complainant(s)

Versus

Religare Health Insurance Company Ltd., - Opp.Party(s)

Pradeep Sharma Adv. & Rohit Malik Adv.

06 Sep 2018

ORDER

The counsel for the complainant states that the complainant took a health policy from the OPs insurance company  and she filed a claim in June 2018  with the insurance company but the OPs company neither provided cashless facility nor made any claim of the complainant despite completing all the formalities and as a result the complainant had to pay the hospital bill from her own pocket.  It is further stated that the OPs only intimated that the claim is under process.

                        We are of the view that once the complainant has lodged her claim and completed all the formalities, the Insurance company is bound to decide the same as per guidelines of the IRDA. Therefore,  without prolonging the issue we direct the OPs to decide the claim of the complainant within 30 days from the date of receipt of certified copy of this order, failing which OPs shall be liable to pay cost of Rs.10000/- to the complainant. In case the complainant is not satisfied with the decision of the OPs insurance company she shall have the liberty  to approach the appropriate Forum for redressal of her grievance under the provision of law.

                        The counsel for the complainant appended a note on the complaint he withdraws the complaint. Accordingly the complaint stands disposed off.

                        Certified copy be sent to the parties free of charge. After compliance file be consigned.