Insurer told to pay up the rejected health claim

In its reply to the forum, the insurance company stated that the complainant had not disclosed the pre-existing illness at the time of taking the policy.

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Insurance Medical Insurance Health policy
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Insurer told to pay up the rejected health claim

CHANDIGARH: The district consumer disputes redressal forum has directed Religare Health Insurance Company Ltd to refund Rs 1.84 lakh and pay Rs 35,000 as compensation for repudiating the claim of a senior citizen.

Complainant Ranjit Minhas, 60, a resident of Sector 21 here, has stated that on December 17, 2016, she was diagnosed with “lymph node” in her right breast, which is a type of carcinoma, while taking treatment at PGI, Chandigarh.

Her husband, who is also a beneficiary in the health policy, informed the insurance company regarding the illness of the complainant to avail medical insurance.

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Claim rejected

But they rejected the health claim on the ground of her suffering from a preexisting disease diabetes.

In its reply to the forum, the insurance company stated that the complainant had not disclosed the pre-existing illness at the time of taking the policy.

But, the forum noted that at the time of taking the Health policy, the complainant’s medical examination was conducted by the insurance company and it was only then that she was issued the policy.