Did New India Assurance overcharge lakhs of mediclaim policyholders? - I

Is New India Assurance sitting on crores of extra premium collected due to a software glitch? It does not even know how many policyholders paid excess premium and is stonewalling all questions

Is New India Assurance trying every trick in the book to avoid returning crores worth of premium collected in a period of nine months due to a software glitch?

It all started with policyholder Anant Meghji Nandu giving a blank cheque to his New India Assurance agent in 2008 for his father's Mediclaim policy. The practice of giving a blank cheque to agent is widespread because there is usually a minor difference between the final premium amount and the quoted amount. In this case, there was additional Rs1,688 added to the cheque by the agent. Mr Nandu wrote to New India Assurance for an explanation in the huge variance between final premium and quoted premium, but they kept a stony silence. He filed an RTI query. He got a reply about a software glitch leading to overcharge and got a refund of the excess premium. He filed another RTI query to find out since when the overcharging was happening. The answer was 16 August 2007. The cat was out of the bag.

Mr Nandu quickly realized that there could be lakhs of policyholders who would be eligible for a refund which can run into crores of rupees. For the larger good, Mr Nandu wanted to ensure that all those who were overcharged also got a refund. He then tried to find about the refund data, but was met with stiff resistance from New India Assurance's Central Public Information Officer (CPIO). To downplay the issue, the company changed its stance. It now claimed that overcharging started only in 29 May 2008, which will mean fewer customers will be affected. But, will the Central Information Commissioner (CIC) accept this contention from the insurer?

The question is how will policyholders know that they were charged approximately Rs1,000-Rs1,500 extra premium in 2007-08? They won't, unless they are really astute in mediclaim premium calculation or happened to stumble across the discrepancy. In the age of technology, how difficult is it for the insurer to find out the policies they collected excess premium? Not difficult, unless they want to feign ignorance or software malfunction is a norm which precludes them from getting the data of policyholders' who paid excess premium.

This is case of heads I win, tails you lose. If by mistake a company charges a lower premium, it will soon detect it and come after you. But if the company overcharges, then they don't know how much extra premium was received. If you ask for refund you will get it; if you don't then you loss seems to be the New India's strategy. Is it fair?

Mr Nandu is a brave man for valiantly fighting the case for over three years at the cost of own money and time to help fellow Indians to get justice?

In our second part of the story we will report on New India Assurance's tactics to save face.

Comments
Right
1 decade ago
Bravo AN(ant) NA(nandu)JI age badho...

Hum Tumhare Sath Hai. ! ! !
dayananda kamath k
1 decade ago
bank s also use the same tactics. here regulators are also of no help. even the finance minsitry primeminsiters office or presidents office which holds the shares of these public sector undertakings on behalf of general public is also of no use. people of india have to suffer silently as nothing moves even on the 60th year of parliamnet session. where members are more concerned with their right and honour and suprimacy than their duty as parliamentarian. since 1968 cag reports are gilotined and country economy was allowed to be mismanaged.
Nagesh Kini
1 decade ago
Roping in Amir Khan to expose Mediclaim fraud on elders is an excellent idea. Go ahead!
arun adalja
1 decade ago
this incidence is a eye opening for ordinary people who just pay whatever is asked for it.everybody cannot do google search to find out the things.i am not able to understand why premium notice is not sent by the insurance companies?do you think they are poor?they cannot spend rs 5 for sending notices.irda must compell them to send notices to all fellow to avoid such things.
d kulkarni
Replied to arun adalja comment 1 decade ago
Its just letahrgy / unionisam / un accountability (govt.owned insurance cos) which results in such delays/mess and harassments to policy holders.

No one is controlling / monitoring such mess at higher ups of PSU/Govt.owned cos. Chairman / CEO and other senior officials have STRONG POLITICAL backing for them to function IGNORING PROFITABILITY OF ORGANISATIONS and harassment to general public/masses who have been paying premiums for couple of years.

CAN WE ALL OF US REQUEST AMIR KHAN / SATYAMEV JAYTE to expose insurance related mapractices affecting common citizen !!!!!
m kumar
1 decade ago
THIS IS A COUNTRY OF FRAUD @ EVERY LEVEL - BOTH BY DESIGN & EVEN DEFAULT.

COMPANIES & ENTITIES PLAY WITH PEOPLE OF THIS COUNTRY UNFLINCHINGLY DESPITE TONNES OF LAWS, RULES.....!

AND THE TOPPING IS THE SO-CALLED REGULATORS, WHO DONT KNOW WHO, WHAT & HOW TO REGULATE ANYTHING NEED REGULATORS FOR THEMSELVES - WHETHER IT IS IRDS, TRAI, SEBI, AMFI OR HORDES OF SUCH CREATED ROBOTS!

A GRAHAK IN INDIA CAN ONLY JAGO & WATCH HIMSELF AT THE RECEIVING END. THERE IS NOTHING HE CAN DO FOR BEING LYNCHED BY ANY ENTITY INCLUDING GOVT. OF INDIA ITSELF - INCOME TAX DEPT, FOR EXAMPLE!

SAAREY JAHAN SE ACCHA HINDUSTAN HAMARA (JO BILKUL HI NAHI HAI)!

JAI HIND!

Harshit Y Tarkas
1 decade ago
This needs a thorough probe. An independent agency should be given this task.
Nagesh Kini FCA
1 decade ago
Raj.
All these comments need to be handed over to the IRDA Chairman with a request that he get the response from the insurance cos and forward them to MLF.
I've mediclaim since 1990s.
I know of Mediclaim Policy 2007 because it forms a part of the current mediclaim policy document.
The issue of 1996 and migration needs to be clarified.
raj
Replied to Nagesh Kini FCA comment 1 decade ago
sure
nagesh kini
Replied to raj comment 1 decade ago
Sure he does eminently deserve the award. who'll present it ?
sanjay
1 decade ago
hi.
I too had a differnt exp with new India. In 2008, I didn't rx the loyalty disc which is 10% OF PREMIUM AMOUNT. My agent told me it is discontd. I still wrote to NIA redressal office with cc to IRDA. I immediately got response along with cheque of Rs 1600+ as adj of loyalty prem. So Pl Chk ghis angle also.
raj
Replied to sanjay comment 1 decade ago
yes, it was loyalty discount which was not given and hence overcharge. There were other reasons for excess like senior citizen charged premium beyond 75% hike, etc.I am glad you got Rs1600 back, but there will be lakhs who did not get it.
VTGokhale
Replied to sanjay comment 1 decade ago
Are you having Mediclaim 1996 policy or Mediclaim 2007? Were you migrated from Mediclaim 1996 to Mediclaim 2007?
captainjohann
1 decade ago
I think this rot is not punishable as national Insurance and United etc are public limited companies. Only the policy holders sufffer. They arbitrarily increase the premium every year without any accountability.
suvarnamk
1 decade ago
Anant M. Naidu be awarded gallantry award.
He persisted & recovered money.
Insurance company cancels policy if an iota of doubt of fraud is noticed.The Aam Adami has to go through legal battle.
The Insurance Act , done so many years ago,deals only with Insurers rights except section 45 -two years time in favor of Insured. Period.
The law is overwhelmingly in favor of Insurers.
The time, requirements & aspiration of Aam Adami have changed drastically.
The Utmost Good Faith is to be applied to both.
The Insurance Act must add Insureds rights for education,information, clarity of terms, representation & right to get justice from the Insurers without the trouble of going to legal recourse.
The Insurer lays down rules of play.When the Insurer has to keep his side of bargain , the Insurer sits as judge.
The party to contract becomes the judge to keep his side of bargain. It is like investigating agency ,it self becomes justice giver.
Even the regulator cannot do anything. The insurer may be warned only.
Only Independent investigator/ auditor can come to conclusion.
Mr. Naidu suffered for more than 2-3 years.
The justice be done as would have delivered if the insured had committed fraud
raj
Replied to suvarnamk comment 1 decade ago
agreed.
surjiy singh
1 decade ago
yhe company shall be compelled to disclose details of all the policy holders.
@) the company shall return the exorbitant amt with penal rate of interst.
3) IRDA must iterfere and direct the company to return the addl amt with penal rate of interest yo all policy holders
4) IRDA shall also direct other insurance companies to check the amt of premium and confirm that exact amt is being collected
raj
Replied to surjiy singh comment 1 decade ago
the 3rd part of the article will talk about IRDA action or inaction to the New India Assurance issue
Nagesh Kini FCA
1 decade ago
We have no choice but to accept the terms and premium rates for mediclaim.It has not been revisited or premia reviewed but hiked arbitrarily without any empirical or mortality or illness studies. "Senior citizens lodge more claims so they have to pay more.' This is mouthed ad nausem even when the New India's RTI response says the claims in the 35-55 age group and corporate policies are the maximum.
The IRDA needs to pull up New India.
Charges for cheating by invoking S.420 need to be considered too.By a class action suit.
mahendra bhatt
1 decade ago
New India assu. not only collects extra amount by way of premium but also avoids to pay the clients the dues against claims even in deserving n genuin cases.It happened with me I put claim for cataract operation a month back of rs.23000 app. I was paid only rs. 10000.reason it was left eye!!!!!!!!!!!!!
Harish Shah
1 decade ago
My friend an agent with United India Insurance co. Ltd. tells me that system error was noticed when United India introduced Platinum, Gold and Senior citizen Plan. In Platinum and Gold plan the sum insured was merged with bonus. Many received policy without or incorrect bonus merger. Discount on the premium was to be given which also many didi not get and some got less discount as bonus was wrong. Those who represented their case got their policy corrected some are stuck with the error as they were told that after two years the error in the policy cannnot be corrected. Changing of Policy Plans and changing of T.P.A. is highly political.
Anadish Pal
1 decade ago
Very commendable on Mr. Nandu's part. It appears profit making and cheating have become very good bedfellows in many businesses.
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