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Mediclaim : HC Directs United India To Reimburse Treatment Cost
The Madras High Court directed United India Insurance Company to reimburse the treatment expenses of Rs44,581.00 with 9% interest to a petitioner, S Dhanalakshmi, who got her baby admitted to a non-network hospital due to an emergency. The petitioner had joined the health insurance scheme in 2012 and was subscribing to it regularly.
 
Justice R Subbiah said that the HC had already advised that a person’s claim should be considered on the satisfactory reason that they were unable to get treated in a network hospital, but had been advised to go to a non-network hospital.
 
In this case, Ms Dhanalakshmi’s son had vomited and she was under the impression it was just food poisoning.  But his condition worsened and she had taken the child to a nearby hospital, where doctors diagnosed it as obstructed hernia and recommended that he should be operated immediately. On their advice, her son had undergone emergency surgery.
 
The petitioner had obtained the necessary certification, of being a genuine case, from the state health authorities. Hence, the insurance firm could not reject her claim on the ground that treatment was done in a non-network hospital, the judge said.
 

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Real Estate : Rs18 Lakh Fine for Developer
A family of Chakroborti VK Kondapalli booked a 1,600sft (square feet) flat in a project by Mahindra Lifespaces at Mumbai and paid Rs1.06 crore in August 2009. The purchase agreement was executed in September and possession of the flat was to be given by 31 October 2010. The family paid the balance Rs86.11 lakh by then. But the developer gave the possession only in February 2012.
 
The family approached the Additional District Consumer Forum for Mumbai Suburban District, seeking interest on the money they had paid at the rate of 12% a year and reimbursement of the amount of the rent they had paid during the delay. The Forum rejected the developer’s contentions, noting that a clause in the agreement—which empowered the developer to charge interest on late payments but restrained the buyer from seeking compensation—was contrary to the law.
 
“Agreements contrary to public policy are void,” said the Forum, while holding the developer guilty of unfair trade practices. The Forum directed Mahindra Lifespaces to pay interest at the rate of 10% a year on the Rs86.11 lakh paid by the buyers, for the period of the delay. The Forum further instructed the developer to reimburse the Rs4.80 lakh that the Kondapalli family had spent on rent during the period and Rs35,000 for litigation costs.
 

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