Insurer told to pay Rs.3.72L to Mohali man
Mohali, April 24 -- The District Consumer Disputes Redressal Commission, Mohali has directed Care Health Insurance Limited to reimburse a mediclaim of Rs.3.72 lakh to a Mohali resident after finding the company deficient in service for rejecting the claim on grounds of a pre-existing disease.
The complaint was filed by Sandeep Singh, a resident of Mohali, whose father Narendra Singh underwent an emergency cardiac procedure at PGIMER, Chandigarh, in November 2021 after being diagnosed with coronary artery disease. The treatment involved stent placement at a cost Rs.3,72,257.
Despite submitting all required documents, the insurance company repudiated the claim in February 2022, alleging that the patient had a 12-year history of hypertension that was not disclosed while purchasing the policy. During proceedings, the commission examined medical records and policy documents and found that the insurer failed to produce convincing evidence. Partly allowing the complaint, the commission directed company to pay the claim of Rs.3,72,257 within two months....
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