[Resolved]  New India Insurance Company — Denial of increase in sum insured for senior citizen policy holder

Address:

Pune, Maharashtra

Hello Sir / Madam,
I have grievance regarding mediclaim insurance and require guidance/advice on the exact position of the rights of the customers vis-à-vis insurance companies.

I have already taken mediclaim policy for sum insured of Rs. 1Lakhs for my mother since 2007 (its in the fourth year now) with a New India Insurance company in India. We now wish to increase the sum insured to Rs. 3 Lakhs for which the company had informed my mother to undergo its pre-medical heath check-up tests based on which the cover will be increased.

Now we have completed the medical test and my mother has tested positively for the stress test, which means she might be at risk of hypertension related heart ailments. The insurance company is denying us any increase in the sum insured based on the clinical findings and claiming that they have a clause in the company guidelines that the company does not increase sum insured cover to any of its customers post 60 years irrespective of the fact that policy holder might have some exclusion related ailments or not, though they have not shown me such guidelines / rule book of the company.

I have asked the company branch manager to given me in writing the clause to which he is referring on which grounds the increase in sum insured is being denied to my mother for which the official is refused put any such thing in writing.

Further as per my understanding all citizens including senior citizens are entitled for insurance cover upto the age of 80, as per recent government directives. I believe the insurance company is denying the rights of my mother by not allowing to increase the sum insured on her existing policy (they can also denying to increase the cover by putting the related clinical findings of heart related ailments into exclusion) amounting to injustice on part of the company dealings with the customers.

Please guide me on the options we have in front o[censored]s to take this matter to appropriate authority and get justice for my mothers case.

Thanks in advance.
- An aggrieved citizen