The Pune District Consumer Disputes Redressal Forum has ordered New India Assurance Company Ltd to pay about Rs 1.35 lakh with an annual interest of 9 per cent for one-and-a-half years to its customer Arundhati Sadavarte for refusing her insurance claim. The company had refused the claim stating that her deceased husband had illness that was suppressed from the company while starting the insurance.

Arun Sadavarte, a resident of Paud Road, had taken a mediclaim policy of Rs three lakh in 2001 from New India Assurance Company. He was hospitalised on February 28, 2008, after he suffered a stroke. “He was in the hospital for five days till he expired on March 3. I had submitted the insurance claim for Rs 1,35,511 on March 27, 2008. However, the company repudiated the claim on May 26, 2008, stating that my husband was already suffering from hypertension and we had suppressed this fact from the company,” said Arundhati.

The insurance company filed a written statement on the basis of certain information given by his brother to a hospital stating that 62-year-old Sadavarte was suffering from hypertension for the last 7-8 years.

According to the court order, the brother disowned this statement in an affidavit. “Other than this statement, the insurance company could not produce any proof of Sadavarte suffering from hypertension,” said advocate D G Sant, counsel for Sadavarte.

While taking the policy, Sadavarte had done a complete medical checkup at Mediassist India Private Limited as directed by New India Assurance Company, Sant said. “The medical records from this lab did not show any record of Sadavarte suffering from hypertension. He again got a health check-up with some other laboratory in 2006-07 before he travelled to the US. Medical records of this check-up, too, did not mention of him suffering from hypertension,” Sant said.

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