Hospitalization not required for health insurance claim...
Vadodara A consumer forum court has said that even if a person is hospitalized for less than 24 hours, he can claim his insurance. On the petition of a person named Rameshchandra Joshi, the Consumer Forum ordered insurance payment to the insurance firm. Since this decision came to the fore, people are expecting improvement in this system.
The vadodara Consumer Disputes Redressal Commission (Additional) said during the hearing of the case that due to the introduction of new technology, sometimes patients are treated in less time or even without hospitalization. If the patient is not admitted or is treated within a short time after admission due to new techniques, the insurance company cannot reject the claim on the ground that the patient was not admitted.
Why the consumer court gave the verdict?
A person named Rameshchandra Joshi filed a complaint against National Insurance Company Limited in august 2017 after the insurance company rejected an appeal. Rameshchandra Joshi's wife had dermatomyositis in 2016. She was admitted to Lifecare Institute of Medical Science and Research Center in Ahmedabad. After receiving care, she was released the following day.
Rameshchandra Joshi claimed Rs 44,468 from the insurance company but the insurance firm rejected it citing Part 3.15 and argued that she was not admitted continuously for 24 hours as per the clause in the policy.
Insurance claims can also be made for a short time
The petitioner placed all the necessary documents before the Consumer Forum and stated that his wife was admitted on november 24, 2016, at 5.38 pm and was discharged on november 25, 2016, at 6.30 pm.
The Consumer Forum, while giving its verdict on the matter, said that even though the patient was admitted to the hospital for less than 24 hours, new-age treatments and medicines have been developed according to which the doctors prescribe treatment.
The court imposed a fine on the insurance firm
The Consumer Forum had also issued an order for the insurance company to pay Rs 3,000 to the petitioner for mental harassment and Rs 2,000 for litigation.
