19 June 2019
National Consumer Disputes Redressal Commission (NCDRC while upholding order of District Forum and State Commission directed ICICI Prudential Life Insurance Company Limited to pay over Rupees 5 lakh to a Maharashtra Resident, whose claim for reimbursement was rejected
he Claim of the Complainant for reimbursement of Medical Expenses was rejected by the Company on the ground of withholding information from them. The Company held that the Complainant had withheld information about his disease at the time of taking the insurance policy and produced a certificate from Doctor claiming the Complainant had been suffering from Diabetes and Hypertension since the past ten years. The Commission, supporting the findings of District Forum and State Commission agreed the said certificate was suspicious as the Doctor was a Pediatrician and directed Registrar of the Commission to refer the matter to the Maharashtra Medical Council, Mumbai, for the appropriate necessary action against the doctor. .Furthermore, the act of obtaining such certificate by the Company was held as "unfair trade practice" within the meaning of the Section 2 (1) (r) of the Consumer Protection Act, 1986.