Legal Question in Insurance Law in India

I had taken a Health Insurance policy with United India Insurance in 1999, and continue to hold the same. Last year during the renewal of the policy ( 2011-12), they included a cap on the room rent @ 1 % of the sum assured, and have restricted the operation charges payable like the Doctor's consultancy, operation charges etc to a proportion of the room rent eligible to the room rent actually paid. In my case as the eligibility and actual room rent paid were Rs 1000 & Rs 1600, they had paid the operation charges in the ratio of 1000/1600 (and deducted around 38 % of the charges. Can they make such important material changes in the terms of the Insurance contract without informing the Insurer during the renewal of the Insurance; especially when there had been no changes in the terms for more than 10 years from 1999 to 2010-11. I had read that it is against the Principles of Insurance, and any changes should be brought to the notice of the other, be it the Insurer or Insured. Can anyone guide in this regard.


Asked on 3/23/12, 11:06 am

1 Answer from Attorneys
Santosh Goswami,Advocate sure shot legal

Whether they can do so or not depends upon the fact that did they make changes according to some new notification by IRDA or they have done it arbitrarily. We have to confirm that. But that they did not inform you before doing so is a clear deficiency on their part for which you can move consumer forum against them. for more at 919555462995

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Answered on 3/29/12, 4:51 am


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