Medical compensation granted after 14 years

After 14 years of draining legal battle, a 50-year-old woman has received a compensation of Rs 3.39 lakh by the Oriental Insurance Company against her medical claim policy.

After 14 years of draining legal battle, a 50-year-old woman has received a compensation of Rs 3.39 lakh by the Oriental Insurance Company against her medical claim policy. The woman had undergone a cardiac surgery at Escorts Heart Institute after purchasing the medical claim policy in 1997, but she was denied claim for medical expenses.

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Referring the long course of court trial as a travesty of justice, 50-year-old Anita Chopra said, "I got relief in more than a decade. The entire concept of consumer friendly court is a myth. My case was delayed and deferred without any logic. This constant delay has created a trauma in me."

Chopra, a resident of Mansarovar Garden in west Delhi, was diagnosed with rheumatic heart disease (RHD), and was advised cardiac surgery, which she underwent in June 1997 at an expense of Rs 2.65 lakh. The insurance company repudiated the claim stating that she had not disclosed her pre-existing disease at the time of purchasing the mediclaim policy.

Talking about her strenuous court trial, Chopra said, "Claiming my mediclaim was an ordeal. I have got no benefits but just pains out of my medical policy. These consumer courts just harass consumers. Despite being a heart patient I had to shout to prove my innocence."

The National Consumer Disputes Redressal Commission in September 2010 directed Oriental Insurance Company to pay Rs 3.39 lakh to Chopra.

"After facing mental agony for so many years, we finally received the compensation cheque in January 2011, five months after the judgement," said Om Prakash Chopra, Anita Chopra's husband.

Initially, the state consumer forum rejected Chopra's plea and did not award any compensation to her. She filed a petition in National Consumer Disputes Redressal Commission, which discarded the lower court observation.

The commission noted that the complainant (Anita Chopra) could have suffered from RHD before taking the medical policy; but it has not been established by the insurance company that she was aware of her disease.