Skip to main content

'Can't deny mediclaim for magnetic treatment of osteoarthritis'

A consumer forum has said Rotational Field Quantum Magnetic Resonance (RFQMR), a non-invasive osteoarthritis treatment, could not be called an alternative or experimental therapy and ordered an insurance firm to pay up for rejecting two claims.
Dismissing New India Assurance Co's argument that the treatment was not recognized by the Indian Medical Council, the forum asked it to pay first complainant Sanyuktaben Shah the insured amount of Rs 1.05 lakh with a compensation of about Rs 46,000, and second complainant Bhisham Lambh Rs 1.30 lakh with a compensation of Rs 40,000.
The forum held that the insurance company had not produced any evidence to show that RFQMR was not recognized by the Indian Medical Council. "Only mentioning the same in the mediclaim policy clause would not be held just and proper for repudiating the claim," it said.
Vile Parle resident Sanyuktaben Shah, in her complaint on 2010, said she came to know about RFQMR about five years ago when osteoarthritis attacked her knee joints. She took the treatment at a Bangalore-based company's Andheri centre in 2008 and was in regular consultation with doctors and physiotherapists as there was still some pain. She also visited a health care centre and was recommended some oral medicines which worked. That year in December, she submitted a claim for Rs 1.05 lakh, which was repudiated.
Juhu's Bhisham Lambh also underwent the treatment after crippling pain in his knees from December 2009. After the 21-day therapy in May 2010, he sent the insurance company a claim of Rs 1.30 lakh. A month later, it was rejected. He moved the South Mumbai District Consumer Disputes Redressal Forum in October 2010.
In both cases, the insurance company said the treatment was experimental and unproven and, therefore, according to the terms and conditions of the mediclaim policy, they were rejected. It stuck to its stand in the forum.
The forum ruled otherwise after taking into consideration the literature produced by the complainants. It showed that RFQMR significantly decreases pain, increases mobility, stability and power of the knee joint, and increases cartilage thickness in osteoarthritis patients. "Furthermore, as per the documents of objectives of Indian Medical Council which is placed on record by the complainant, it appears that the council does not have any object to approve any specific treatment or disapprove any treatment," the forum said.

Comments

Most viewed this month

The recovery of vehicles by the financier not an offence - SC

Special Leave Petition (Crl.) No. 8907  of 2009 Anup Sarmah (Petitioner) Vs Bhola Nath Sharma & Ors.(Respondents) The petitioner submitted that  respondents-financer had forcibly taken away the vehicle financed by them and  illegally deprived the petitioner from its lawful possession  and  thus,  committed  a crime. The complaint filed by the petitioner had been  entertained  by  the Judicial Magistrate (Ist Class), Gauhati (Assam) in Complaint Case  No.  608 of 2009, even directing the interim custody of the vehicle (Maruti  Zen)  be given to the petitioner vide order dated  17.3.2009.  The respondent on approaching the Guwahati High  Court against this order, the hon'ble court squashed the criminal  proceedings  pending   before  the  learned Magistrate. After hearing both sides, the Hon'ble Supreme Court decided on 30th...

Owner of vehicle is not expected to verify the genuineness of the driving license before appointing a driver

Cause Title : Rishi Pal Singh Versus New India Assurance Co. Ltd & Ors., Civil Appeal No. 4919 Of 2022, The Supreme Court Of India Date of Judgment/Order : July 26, 2022 Corum : Hemant Gupta; J., Vikram Nath; J. Background the truck owned by the appellant met with an accident. The owner deposed before the court that before employing the driver, he had taken his driving test and that he was driving the vehicle satisfactorily and  that the driver was employed with him for 3 years before the date of the accident. He produced his driving license. This was reaffirmed by the driver who deposed that the driving license was obtained from the driver and it was issued from Nagaland, but no such license was produced on record. Both the Motor Accident Claims Tribunal and the High Court have held that the owner has alleged that the driver had a driving license from Nagaland but the same was not produced and therefore, the Insurance Company is entitled to recover the awarded amount...

Person Being Prosecuted To Be Provided With All Relevant Documents

The Delhi High Court, in the case of Poonam Jain vs Union of India & Ors, noted that a person being prosecuted against has a right to be provided with all the material relied upon by the prosecuting agency to prosecute her/ him. In the instant case, a search was conducted at the residences of the petitioners and their statements were recorded and several documents were seized. They were issued show cause notices under Section 276 C(1) and Section 277 of the Income Tax Act, Section 181 of the Indian Penal Code and Sections 50 and 51 of the Black Money (Undisclosed Foreign Income and Assets) and Imposition of Tax Act. They sought to be provided with a copy of their statements and the documents seised. However, the same was denied to them.