Ahmedabad: Consumer Court here has ordered an insurance company to replace expenses for medical care for lung cancer after the company rejects Mediclaim on the grounds that patients are chain smokers and contract due to smoking.
The consumer court said there was no evidence that cancer was caused by patient smoking habits.
The case involved one Alok Kumar Banerjee from Thaltej, who underwent treatment for the lung adenocarcinoma of the Vedanta Institute of Medical Science in July 2014 and RS 93,297 medical bill occurred.
He has medical insurance protection.
But the claim is rejected by the insurance company.
After Banerjee died, his wandering wanders sued insurance companies in 2016 at the consumer dispute commission, Ahmedabad (additional), where the insurance company took the defense that Banerjee was treated in various hospitals for his illness, which had Nexus directly with him.
Smoking habits, and that this is reflected in the case paper.
Consumer commissions do not agree.
It quotes a higher forum command and says that the summary of the release itself cannot be treated as the main or conclusive evidence in the absence of independent evidence.
There is no evidence in this matter to show that patients suffer from cancer because of smoking.
The insurance company doctor gives medical opinion that those who smoke have a risk of 26 times higher exposed to cancer.
For this, the Commission said that only based on this opinion, it cannot be concluded that patients suffer from cancer because of their smoking habits.
Those who do not smoke also get lung cancer and cannot be believed that everyone who smoke has lung cancer.
It is unacceptable that the complainant husband gets cancer because of the smoking habit and insurance company wrongly reject the claim, add commissions.
In addition to ordering insurance companies to restore medical expenses, the Commission has asked to pay an extra 5,000 Rs to compensation for compensation for mental harassment and legal expenditure.