ISLAMABAD: President Dr Arif Alvi has recently upheld the decision of the Federal Insurance Ombudsman (FIO), which directed the United Insurance Company of Pakistan to reimburse the full health insurance amount of 57,172 Australian Dollars (AUD) to one Fahad Mahmood.
The insurance company had denied the insured amount on flimsy grounds, citing that Mahmood’s father was admitted to the hospital for the second time due to pre-existing ailments, which he did not disclose at the time of obtaining the policy.
The FIO had passed an order in favour of Mahmood, saying the company had the obligation to ensure the protection of the interests of insurance policyholders. The president, in his decision, agreed with the FIO’s observation and stated that the company had all means at its disposal to ascertain pre-existing ailments before issuing the policy.
He further added that without going through due process, the issuance of policy creates such situations, which can lead to maladministration on the part of the insurance company.
The president also mentioned that the company’s repudiation of the second admission claim on flimsy grounds while honouring the first admission claim was unjust, unreasonable, and based on irrelevant grounds.
Therefore, he directed the company to reimburse the full health insurance amount to Mahmood within 30 days.
