13 February 2012
The Mumbai Suburban District Consumer Disputes Redressal Forum has directed an insurance company to pay a Parkinson’s patient his insurance dues, which was denied by the company on the grounds that he had not undergone allopathy treatment and had opted for Ayurveda treatment.
The Consumer forum has ordered New India Insurance Company to pay Kantilal Hariya, a Santacruz resident, Rs 72,000 along with an additional 10 per cent interest on the amount since May 2008, when the complaint was registered with the forum.
The complaint says Hariya, a Parkinsons patient, had undergone Ayurvedic treatment for a month at an Ayurveda centre. The treatment had cost him Rs 38,452. Hariya had undergone similar treatment a year ago.
However, when he approached the insurance company for reimbursements of the hospitalisation expenses, the company denied it saying only allopathy treatment is accepted under the insurance policy.
It also said that in the case of homoeopathy and Ayurveda, only 25 per cent of the total bill could be reimbursed provided the treatment was done in a government hospital.
According to Hariya, no such conditions were mentioned to him while opting for the policy. However, the company brought to the forum’s attention that a new condition was introduced when Hariya renewed his policy in 2008. However, Hariya was not informed about this condition.