The forum on Thursday suggested a major change in the insurance policy issuance system while delivering a verdict in a case brought by an aggrieved client against The New India Assurance Company over a Covid insurance claim in the city.
IC Shah, chairman of the Vadodara Consumers Dispute Redressal Commission, observed in the decision “Not only educated people, but even illiterate or less educated people take out mediclaim (health insurance) policies and do not understand the English language. Even the educated people find it difficult to understand the technical language in the political conditions, so it would be difficult for the illiterate or less educated to understand it.”
“We believe that the time has come for insurance companies to issue policy conditions and clauses in regional languages and that too in a way that could be easily understood. It should also be short so that people common people can understand the legal aspects of the policy they have purchased or are considering purchasing,” Shah said in the judgment which also mentioned that the fonts used in the policy terms were too small, making reading difficult.
The observations were made during the decision in a case filed by Bina Shah against The New India Assurance Company in 2021. Bina was admitted to hospital after being infected with Covid in 2020. She filed an insurance claim of Rs 1.95 lakh but citing conditions, the insurance company deducted Rs 1.19 lakh from the claim.
Bina said in her complaint that the company did not explain or provide a copy of the terms of the insurance policy to her. The insurance company rejected part of the claim citing its own clauses and the notification from the Vadodara Municipal Corporation regarding the hospital expense package. The court ruled in favor of Bina and ordered the company to pay Rs 1.19 lakh to Shah within two months and with 9% interest from the date the claim was filed.
The insurance company will also have to pay Rs 5,000 for bullying and expenses worth Rs 5,000 to the plaintiff. A copy of the order will be sent to the regional manager of the insurance company so that he can follow up on the suggestions made by the court.