Complaint was opposed by the respondent/OP No. Finding deficiency in service on the part of respondents /OPs, appellant/complainant filed a complaint before the District Forum seeking the total value of claim i.e. 1 neither settled the claim nor gave any response. It is stated that appellant/complainant got issued a legal notice dated calling upon the respondent /OP No.
1 on for settlement of his claim, however, the claim was not settled. It is stated that thereafter appellant/complainant submitted all the documents consisting of Claim Form, Medical Expenses bills, etc. 1 denied to pay medical expenses to hospital against the cashless medical policy. against the mediclaim insurance policy of Rs. 27,700 only by the TPA of respondent/OP No. 1 did not confirm the payment to the hospital and the patient was released after the sanction of Rs. It is stated that despite aforesaid payment, the patient was not released due to the reason that respondent/OP No.
Mediclaim united india insurance company full#
51,700 on in full settlement of hospital bill of Rs. It is stated that appellant/complainant deposited Rs. It is stated that the hospital further directed the appellant/complainant to deposit further payment as respondent No. 20,000 as advance which was duly paid on. The appellant/complainant informed the hospital that he was covered under a valid cashless medical insurance policy with the OP, therefore, medical bills for all expenses be issued to OP Insurance Company, however, the appellant/complainant was insisted upon to pay Rs. Mala Lamba was performed with two surgeries at Bhatia Global Hospital & Endosurgery Institute on. It was stated that as per advice of medical consultant wife of the appellant/complainant Mrs. It is stated that the policy was a cashless policy. 1 for himself and his family members, namely, Mrs. the complainant before the District Forum stating therein that appellant/complainant had taken a mediclaim insurance policy from respondent/OP No. Briefly facts relevant for the disposal of the present appeal are that a complaint under Section 12 of the Act was filed by the appellant herein i.e. 165/2015 whereby the aforesaid complaint has been dismissed.Ģ. This is an appeal under Section 15 of the Consumer Protection Act, 1986 (in short, the “Act”) against order dated passed by the Consumer Disputes Redressal Forum (Central) Delhi (in short, the “District Forum”) in Complaint Case No.
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