The Vadodara Consumer Disputes Redressal Commission said hospitalisation isn’t mandatory for medical insurance payout. The consumer court said that with new technologies, people are being treated quickly, and that too, without hospitalisation.
New Delhi,UPDATED: Mar 15, 2023 20:19 IST
Insurance companies insist on hospitalization for at least 24 hours for consumers to claim medical insurance benefits.
By India Today News Desk: In an order that is going to empower citizens, a consumer court in Vadodara has ruled that hospitalization isn’t mandatory to claim medical insurance.
Insurance companies insist on hospitalization for at least 24 hours for consumers to claim medical insurance benefits. This is other than the medical services that are covered under day-care scheme, which need no hospitalisation.
ALSO READ: Everything that you ever need to know about Health Insurance
With new technologies, people are being treated quickly, and that too, without hospitalisation, observed the Vadodara Consumer Disputes Redressal Commission, The Times of India reported.
“If the patient isn’t admitted, or is treated in less time a after being admitted due to new techniques, the insurance firms can’t reject the claim by saying that the patient wasn’t hospitalised,” the consumer court said.
The consumer court ordered the insurance company to pay Vadodara resident Rameshchandra Joshi, who had filed a complaint against the insurance company in August 2017 after it rejected his claim. Joshi had filed for an insurance claim of Rs 44,468.
ALSO READ: How to pick the best health insurance policy?
The insurance company cited a relevant clause and rejected Joshi’s claim, saying he didn’t fulfill the mandatory criterion of being hospitalized for 24 hours.
The court also ordered the insurance company to pay Joshi Rs 3,000 for mental harassment and Rs 2,000 towards litigation costs.
