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Unit Trust of India Technology Services Ltd (UTITSL) and New India Assurance Company Ltd have been directed by a consumer forum here to pay Rs 25,000 to a policy holder for taking over two years to reimburse his medical bills.
The Central District Consumer Disputes Redressal Forum said the policy holder had completed all formalities of filing the claims for reimbursement of medical bills by November 9, 2009 but UTITSL and the insurance firm took more than "reasonable time" to settle the same.
"The opposite parties (UTITSL and insurance firm) took more than reasonable time to process the claim and to settle the same. It amounts to deficiency in service. Since, it was not done in time, therefore, both the opposite parties are liable jointly or severally for causing deficiency in service which led to harassment and mental agony," the bench presided by B B Chaudhary said.
It directed UTITSL and the insurance firm to pay Rs 20,000 as compensation and Rs 5,000 as cost of litigation.
The forum's order came on the complaint filed by Delhi resident Mahender Pal Paliwal, who had said he had purchased 1840 units of Senior Citizen Unit Plan in 1994 and under the plan he and his wife were entitled to medical cover of Rs 5 lakh.
He had alleged that despite completing all formalities by November 2009, his claims for reimbursement of medical bills were neither processed nor settled by UTITSL or the insurance firm.
He said the claims were settled only after he filed the complaint.
In its written statement, UTITSL had said it had forwarded Paliwal's claim to the insurance firm which was responsible for settling it.
The insurance firm in its reply had contended that the documents submitted before it were incomplete, so they were not examined.