20 October 2023, 02:00 AM IST Iconic Image | Photo: Mathrubhumi
Kochi: The Ernakulam District Consumer Disputes Redressal Commission says that requiring 24-hour hospitalization for insurance coverage is a violation of consumer rights. The Commission stated this while considering the petition related to the rejection of the insurance amount on the grounds of lack of hospitalization. The commission ordered the insurance company to pay Rs 57,720 as compensation to the customer whose claim was rejected within 30 days.
The complaint is from Johnny Milton, a resident of Ernakulam Maradu.
Amma’s eye surgery was done without staying in the hospital. Universal Sompo approached the General Insurance Company for medical expenses but the application was rejected. Due to lack of 24 hour hospitalization, O.P. This was considered treatment.
If 24-hour inpatient treatment is required and the treatment is completed in less time with the help of modern technology, the insurance cover is eligible. The Commission also considered the Insurance Regulatory Authority of India’s (IRDAI) circular that specific injections used for the treatment of myopia would be covered under insurance. The commission also found that the insurance company allowed the same claim to another policyholder while the complainant’s demand was pending.
District Consumer Disputes Redressal Commission President D.B. Binu, members Vaikom Ramachandran, T.N. It was ordered by the bench of Srividya and others.
2023-10-19 20:30:00
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