E-Paper
Clear Mumbai’s Andheri man’s mediclaim of ₹3 lakh, pay 6% interest
The forum was hearing a complaint filed by Andheri resident Rajendra Saraf against an insurance company for rejecting his mediclaim for his wife’s treatment in 2012. The company had rejected the claim, observing that the family did not mention the treatment availed by his wife for hypothyroidism, C hyperlipidemia and nose congestion in 2009, when they enrolled for insurance in 2010.
The District Consumer Dispute Redressal Forum recently directed an insurance company to clear a man’s mediclaim of Rs.3 lakh, pending since 2012, with 6% interest from 2017,on the grounds that the money cannot be denied if the patient has disclosed details of pre-existing ailments. The forum also asked the company to pay Rs.30,000 to the man as compensation for mental agony and legal expenses
The forum was hearing a complaint filed by Andheri resident Rajendra Saraf against an insurance company for rejecting his mediclaim for his wife’s treatment in 2012. The company had rejected the claim, observing that the family did not mention the treatment availed by his wife for hypothyroidism, C hyperlipidemia and nose congestion in 2009, when they enrolled for insurance in 2010. Saraf had admitted his wife to a city hospital after she suffered a paralytic attack in January 2012. After she was discharged, the couple approached the insurance company to reimburse the medical expenses of Rs.3 lakh.
According to the forum’s order, while submitting the record of medical treatment, the doctor mistakenly mentioned that the patient was treated for mellitus, hypothyroidism and bronchial asthma. The couple later got it corrected and removed bronchial asthma.
