A consumer forum here has dismissed a plea seeking mediclaim of Rs three lakh for a man, who died of mouth cancer, noting that the disease was reported within a month of taking the policy and according to the terms there was no deficiency on the part of the insurance company.
The New Delhi Consumer Disputes Redressal Forum, presided by C K Chaturvedi, rejected the plea filed by the kin of Delhi resident Narender Chhabra, against IFFCO Tokio and Paramount Health Services Pvt Ltd.
In its order, the forum noted that the complainants failed to rebut the conditions of policy that the disease, which incepted within 30 days of the policy, was excluded.
"In this case, even if we pay no attention to hypertension and diabetes for 12 years or to chewing of tobacco for 15 years, the deceased reported cancerous growth in mouth within one month of taking the policy," it said, while dismissing the complaint.
The complainants had told that Chhabra, who had a Med- shield Policy of the insurance company, was admitted in Rajiv Gandhi Cancer Hospital in December 2008 where he died of mouth cancer in March 2009.
Later, they filed a claim of Rs three lakh with the insurance company for the treatment incurred in the hospital.
The insurance company had contended before the forum that the claim was repudiated on the ground that a disease which incepts within 30 days of the commencement of insurance cover, was excluded in terms and conditions of the policy and added that Chhabra had history of diabetes and hypertension for 12 years and was chewing tobacco for 15 years.
Article referred: http://www.business-standard.com/article/pti-stories/consumer-forum-dismisses-plea-seeking-mediclaim-for-cancer-114082800677_1.html
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