The appelate consumer court fined the woman Rs 1 lakh
The National Consumer Disputes Redressal Commission (NCDRC) has imposed a fine of Rs 1 lakh on a Mumbai-based woman for committing "insurance fraud".
Nina Thackersey had approached the Maharashtra State Consumer Disputes Redressal Commission (MSCDRC) and won a compensation of Rs 52 lakh from an insurance company for rejecting her claim.
The NCDRC, hearing the company's appeal, reversed the order on Thursday.
It held that Nina Thackersey committed "insurance fraud" by hiding facts about her health while buying the policy.
The woman had bought an overseas mediclaim policy from the New India Assurance Company in April 2010.
She suffered upper abdominal pain during a trip to Zurich in May 2010 and was admitted to a hospital there. Upon returning, she filed insurance claim.
The company rejected the claim on the ground that she suffered abdominal pain due to alcoholic pancreatitis and liver cirrhosis, as ailments related to alcoholism were not covered under the policy.
It also said that she had diabetes which she did not disclose while buying the policy.
Ms Thackersey moved the Maharashtra State Consumer Disputes Redressal Commission, which ruled in her favour and asked the insurance company to pay her Rs 52 lakh.
The insurance company then knocked on the doors of the NCDRC.
After going through the documents, the Delhi-based appellate body held that there was a "pre-meditated" attempt to commit an insurance fraud.
"The MSCDRC erred in holding deficiency in service and unfair trade practice on part of the insurance company as every part of the insurance claim was under question," the NCDRC observed.