BENGALURU: Hypertension and diabetes aren't illnesses and can't be grounds to disclaim medical insurance coverage for most cancers remedy, dominated a Bengaluru court docket and chided the high-handedness of a personal insurance coverage agency in denying a affected person his rightful declare in the direction of remedy.
The court docket ordered the agency to pay the petitioner - a most cancers affected person -the insurance coverage sum of Rs 5 lakh with curiosity and compensation of Rs 1.1 lakh for the agony prompted.
The 60-year-old man, an Indiranagar resident, had bought a household cowl insurance coverage coverage from Religare Well being Insurance coverage Firm on November 4, 2011. He renewed the coverage yearly with out fail. In 2018 he was identified with most cancers. His remedy at HCG Hospital price him near Rs 11 lakh.
As his remedy bills mounted, he approached Religare Well being and offered his medical payments hoping for a refund of Rs 5 lakh, the insured sum.To his shock, the insurance coverage firm rejected his declare stating that he had not disclosed his pre-existing situations of hypertension and diabetes when taking the coverage. He sought a proof for the denial however the firm failed to provide him one. After a number of months, he lastly despatched Religare a authorized discover and sued them within the Bengaluru Rural and City 1st further district shopper disputes redressal discussion board in Shantinagar for unfair commerce practices.
In court docket proceedings lasting near eight months, judges of the Bengaluru shopper discussion board slammed Religare Well being Insurance coverage for high-handedness in the direction of a most cancers affected person and including to his current trauma. The Supreme Courtroom in quite a few judgments has noticed that situations like BP and diabetes aren't illnesses however frequent bodily problems and is not any floor to disclaim rightful insurance coverage cash to sufferers. On this case Religare confirmed no concern for an ailing affected person who paid his premium diligently, the judges stated.
On March 29, 2022, the town shopper court docket dominated that Religare Well being Insurance coverage Firm should pay the most cancers survivor Rs 5 lakh insurance coverage declare in the direction of his remedy with 12 per cent curiosity. The court docket additionally directed the insurance coverage agency to pay Rs 1 lakh in the direction of damages for inflicting psychological agony and a further Rs 10,000 in the direction of court docket bills.