Medical problems cannot threaten a claim

mediclaim rejection court case of manmohan nanda abroad

According to a report, Manmohan Nanda had bought an overseas mediclaim business and holiday policy to travel to the US.

Upon arrival at the San Francisco airport, he suffered a heart attack and was admitted to a hospital, where he underwent angioplasty, and three stents were inserted to clear the blockage from the heart vessels.

Thereafter, he claimed the cost of the treatment Insurance company, which was later rescinded saying that he had a history of hyperlipidemia and diabetes, which were not disclosed at the time of purchasing the insurance policy.

The apex court, however, held that the rebuttal of the policy by United India Insurance Company was illegal and not in accordance with law. The court said that the object of purchasing a mediclaim policy is to seek compensation in respect of sudden illness or disease which is not expected or imminent and which may occur abroad.

Suppose, the insured suffers from a sudden illness or disease, which is not explicitly excluded under the policy. In that case, it is the duty of the insurer to compensate the appellant for the expenses incurred thereunder.

Amit Chhabra, Head of Health and Travel Insurance, Policybazaar.com said that if your policy covers any disease, the insurer has to honor the claim. Further, if certain diseases are not explicitly mentioned in the ‘Exclusion List’ of the policy document, in that case also the insurer will have to pay the claim.

Naval Goel, Founder and CEO, PolicyX.com, said that this is a good move for policy buyers who buy health insurance to avail financial assistance during any medical emergency as they are fully aware of their respective health conditions. Rely on the commitments made by the insurers.