New India Insurance Company Ltd
Non settlement fo mediclaim

I have a medi-claim policy No.060100/4/8/08/97/00001772 from Ahmedabad Branch of the company. Due to accident I was admitted in the Hospital on 23/2, after discharged from the hospital, I submitted a claim through TPA on 23/2 and which was granted on 19/3, my treatment was continued and due to pain I have to admitted again in the hospital on 5/3 and got operated on my left leg. The details of my admission in the hospital was informed to TPA on the same day, after discharged from the hospital on 7/3 I informed TPA on the same day.

After surgery, my follow-up treatment was continuing, and after completion of the treatment on 9/4, I submitted my claim for Rs.46428/- on 15/4 i.e. within time limit. on inquiry fro the claim status, it is informed by TPA Office that t I have to contact to the Company office, so I contact Mr. Gupta who is the Divisional Manager, he told me that as and when decision taken, you will be informed. But no information received from the Divisional Office I wrote a letter to Regional Manager at Ahmedabad on 18/8 for the status of my claim, but no reply from his office, I approached to the office of the Insurance Ombudsman (Gujarat) vide my compliant No.11/004/0240/10 dated 8/10.Ombudsman hold hearing on 28/10. After hearing Ombudsman pronounced his award on dated12.11.2009 and directed Company to pay a sum of Rs, 46428/- along with interest @8% from 15.5.2009 till date of settlement of complaints as full and final settlement of the claim.

I have given my acceptance of the award in respect of my claim to Regional Manager at Ahmedabad on 18.11.2009

Then after I requested to Regional Manager and Divisional Manager to settlement of my claims, I wrote several letters to company, but till date I am not in receipt of the payments. Kindly brought to the notice of my grievance to the higher authority of the company to settle my claims.

C.L.PATEL

Company: New India Insurance Company Ltd
Country: India

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