Vadodara: The weakness and body of illness because anemia cannot be seen as a slum or causes of nutritional deficiency, ruling the consumer court here.
The court recently ordered the National Insurance Company Ltd to pay the maintenance fee of RS 33,820 to Bhatt Ashish complainants along with a 9% interest and compensation of Rs 10,000, because insurance companies cannot prove their claims that the condition of Bhatts is due to nutrition.
deficiency.
Bhatt has approached the consumer court in August 2015 as a third party administrator on behalf of an insurance company has rejected his claim which states that treatment associated with nutritional deficiency is not paid in accordance with the terms and conditions of the health insurance policy.
The insurance company also states that anemia is a nutritional deficiency in a claim rejection letter.
Bhatt was treated at a private hospital in Nizampura for five days in May 2015 for problems related to his condition.
Bhatt, in his complaint, had told the court that insurance companies never gave him a copy of policy terms and conditions.
The court upholds the argument that a copy of the terms and conditions have never been given to Bhatt, but also attracts attention that it cannot be assumed that anemia conditions are caused by malnutrition or by not having the right food.
“Insurance companies should prove the nutrient holder by giving a doctor’s opinion and nutritional deficiency cannot be the only reason anemia.
So, insurance companies have made a decision to refuse claims by exceeding their strength and landfill on behalf of insurance companies have also decided on assumptions , “said the court.
Guj: insurance company to pay anemia men’s hospital bills
