Page 49 - The Insurance Times May 2021

Trio cheats government hospitals of Rs. The judge ordered, "This matter requires consideration, in
1.7 crore CM's insurance scheme money, as much as the Insurance Regulatory and Development
Authority of India ought to place on record the basis on
held which approval has been granted for such insurance policies."

A complaint had recently been lodged at the city police The court's direction came on a petition by one Subhash
commissionerate on behalf of Medi Assi Pvt Ltd, a third Khandelwal, who has an insurance policy from Max Bupa
party involved in the insurance scheme of the government, Health Insurance Company Limited. Mr. Khandelwal's case
that the sum had been sanctioned by the United India is that he has regularly been paying the insurance premium
insurance firm to be deposited in a few government for the sum assured of Rs. 35 lakh. Recently, when he raised
hospitals' accounts through their firm as the public made
use of the insurance scheme for various medical treatments. a claim with the insurance company in respect of his mental
illness, he realised that there is a clause in the policy
The cybercrime wing of the CCB filed a case and probe restricting the sum assured to Rs. 50,000, with a few
revealed two from Medi Assi Pvt Ltd, Gunasekaran and conditions, in case of mental illnesses.
Saravanakumar, diverted the sum to their accounts.
According to the police, the duo also created a savings
account in the name of the CM's medical insurance scheme 7 held for duping insurance policy
in Indian Bank in Tiruvallur through another person called holders in Ghaziabad
Kamal Haasan and diverted the money there too.
Police have recently arrested 7 people in Ghaziabad for
The trio was held and remanded in judicial custody. Rs. 8 allegedly duping hundreds of insurance policy holders of
lakh in cash, 13 sovereigns and a car was seized. crores of rupees.The arrested included two women. The
HC asks IRDAI to explain basis for accused have been identified as Pradeep, Rahul, Sumit,
Rupesh, Akshay, Jyoti and Pink.
approving policies
According to an officer, the accused operated a fake call
The Delhi High Court has asked IRDAI to explain on what centre and obtained data of policy holders. They used to
basis it was approving insurance policies that excluded ask people not encash their insurance amount, offering
mental conditions from full coverage, noting that "a large
number of insured persons would be affected by such an more incentives. They used to take renewal amount raging
insurance policy". from Rs. 1 lakh to 5 lakh from policy holders in their bank
accounts, which they closed after withdrawing the money.
Justice Prathiba M. Singh said that a perusal of the Mental
Healthcare Act of 2017, makes its clear that "there can be Police have recovered 11 mobile phones used in commission
no discrimination between mental illnesses and physical of crime, a cheque book, laptop and 6 ATMs cards from
illnesses and the insurance provided in respect thereof". them. T

Criti-Care: Bajaj Allianz General Insurance introduces critical illness policy

Bajaj Allianz General Insurance has recently announced the rollout of a critical illness policy named Criti-Care. While
the entry age for adults is 18 years to 65 years and that for children is 3 months to 30 years, there is no exit age under
the scheme as the renewal is applicable for lifetime. The policy is a benefit only policy which means that it pays a lump
sum amount to the customers if diagnosed with the listed ailment. The sum insured under each section ranges from
Rs. 1 lakh to Rs. 50 lakh and the maximum total sum insured of the policy is Rs. 2 crore.
Criti-Care allows the customers to plan their coverage by selecting any or all 5 sections within the policy, waiting period
as well as survival period. The 5 sections under the policy are cancer care, cardiovascular care, kidney care, neuro care,
transplants care, and sensory organ care. It covers 43 critical illnesses, which include both initial and advanced stages.
"We have observed that many people are becoming susceptible to critical illnesses due to changes in lifestyle, amongst
other causes, and the treatment costs for such ailments can substantially affect a person's financial health. With our
modular product Criti-Care, our aim is to not only allow our customers the freedom to design their policy as per their
needs, but also provide them with much needed support through additional benefits like dialysis care, physiotherapy
care, among others, that can help them with faster recovery", remarked Tapan Singhel, MD & CEO, Bajaj Allianz
General Insurance while commenting on the launch.

The Insurance Times, May 2021 49