Health insurance frm asked to pay Rs 3 lk to claimant

Health insurance frm asked to pay Rs 3 lk to claimant
Health insurance frm asked to pay Rs 3 lk to claimant

A consumer court of Thane has ordered a health insurance company to pay Rs 3 lakhs to a claimant as it failed to prove that his wife was suffering from a disease prior to issuance of the policy.

Complainant Dilip Mohite informed the Thane District Consumer Redressal Forum that he had taken a floater insurance for Rs 3 lakh for his family members, including wife and two children, from Star Health and Allied Insurance Company.

In June 2012, his wife fell ill and had to undergo an angiography and angioplasty, for which he had lodged a claim of Rs 3 lakh with the insurance company.

However, the insurance firm rejected the claim stating that it was a pre-existing disease which Mohite had concealed at the time of taking the policy, and thus rejected it.

Mohite then approached the forum seeking a claim of Rs 3 lakh and Rs 50,000 as compensation.

The insurance firm said it was observed that there were 90 per cent blockages (in heart) detected on the patient, which meant that it had taken a long time to develop and can be treated as pre-existing, and hence it rejected the claim.

Forum president Shena Mhatre and members Madhuri Vishwarupe and ND Kadam gave the definition provided by a court ruling in a case that “pre-existing disease is one for which the insured should have undergone hospitalisation or undergone long treatment or operation.”

The insurance firm had not produced any proof of the claimant undergoing any treatment of heart ailment prior to the present illness, and hence the contention that the disease was pre-existing cannot be accepted, the forum noted.

As there is no proof whatsoever of the claimant having been treated or admitted for any heart ailment prior to the taking of the policy, the reasons given by the insurance company cannot be accepted, it observed.

Thus, the forum last week ordered the insurance company to settle the entire claim amount of Rs 3 lakh to the complainant along with a compensation of Rs 10,000.

( Source – PTI )

Asbestos-related cancer: NHRC notice to health, environment ministries

The National Human Rights Commission (NHRC) Wednesday issued notice to the health and environment ministries on a report that asbestos-related cancer was on the rise in India.

Toxics Watch Alliance, an NGO fighting for environmental protection, alleged that about 50,000 Indians die every year because of asbestos-related cancer.

“The complainant sought the commission’s intervention for a ban on the use of Chrysotile Asbestos (white asbestos), which is hazardous for the health of people and causes various incurable diseases,” an NHRC statement said.

White asbestos is a fibrous material used for building roofs and walls.

The NGO cited contradictory positions of the government on the issue, alleging that though the mining of asbestos has been technically banned by the government, it allows its import and “that too from the countries which do not prefer its domestic use”.

“The commission has issued notice to the secretaries of ministries of chemicals and fertilizers, environment and forests, health and family welfare, industry and commerce and labour and the chief secretaries of all the states and union territories, calling for status reports within four weeks on the issues raised in the complaint,” the statement added.

Activists demand higher allocation for education, health

Civil society activists Tuesday urged the government to increase allocations for various social schemes, especially those related to health and education, as they directly impact the lives of the poor.

“We have recommended that the 12th Five Year Plan (2012-17) should provide more opportunities to the marginalized sections and increase investments in public service such as health, education, skill development, training and infrastructure building,” said Amitabh Behar, national convener for NGO Wada Na Todo Abhiyan (WNTA), which prepared the recommendations along with other 600 such organisations spread across the country.

This is the first time the views of civil society have been invited for the approach paper, which is the blueprint of the Five Year Plan. The activists have already submitted their recommendations to Planning Commission Deputy Chairman Montek Singh Ahluwalia.

Behar also expressed dissatisfaction with the present GDP growth-oriented model of all Five Year Plans. “It should focus on providing equal opportunities to all,” he told reporters.

But, the activist also expressed reservations whether their recommendations would be heeded by the commission.

“Some documents which are there on the Planning Commission’s website show that the recommendations we gave have been diluted,” Behar said.

Health of citizens is wealth of nation: Court

‘The health of the citizens is the wealth of the nation’ and it cannot be allowed to be jeopardized, the Delhi High Court said Monday while slamming an anti-quota stir at the All India Institute of Medical Sciences (AIIMS) in 2006.

The division bench of Chief Justice Dipak Misra and Justice Sanjiv Khanna said: ‘The doctors, residents, interns, the para-medical staff or any other person connected with AIIMS could not have gone on strike…, therefore, their said action is declared illegal.’

The court was hearing a public interest litigation filed by the Scheduled Castes and Scheduled Tribes Medical Association against the anti-quota strike in 2006.

Concerned over the public interest involved in the issue, the court said: ‘All concerned with the AIIMS must dedicate and devote themselves for its excellence keeping in mind that the health of the citizens is the wealth of the nation and the same cannot be allowed to be jeopardized.’

The petitioner’s counsel Prashant Bhushan earlier sought action against AIIMS management for allegedly supporting the strike and not taking action against agitating doctors.

Bhushan argued that defying the Supreme Court ruling, the doctors had gone on strike repeatedly in July 2006 protesting the government’s decision to reserve 27 percent seats in higher educational institutions for students of other backward classes.

Seeking identification of the doctors who had struck work, the lawyer said the apex court, while dealing with a petition on AIIMS doctors strike in May 2006, had said the strike by doctors was illegal.

The AIIMS counsel submitted that the then AIIMS director had not maintained any record about the striking doctors and many of them have already left the institute.

Rapping the AIIMS, Chief Justice Misra said: ‘The authorities of AIIMS cannot get away by taking a specious plea or a mercurial stand that though there was a strike, yet they are not aware who were actually involved in the strike.’

The court also said that it is the responsibility of AIIMS authorities to see that no one in the institute shows any kind of deviancy by taking recourse to strikes, protest or demonstrations and he who engages himself in such activity would be liable for disciplinary proceedings and also for the contempt of this court.

‘The president (union health minister) of AIIMS shall constitute a high powered committee to conduct an inquiry to find out who were the persons who participated in earlier strikes and thereafter on such identification proceed against them as per law,’ said the court.

AIIMS doctors went on a flash strike on four occasions in June-July 2006 over the issue of increasing political interference in the institution by the then union health minister Anbumani Ramadoss.

The doctors decided to go on strike following the controversial sacking of P. Venugopal, then director of AIIMS.

Venugopal challenged his sacking in the court and the strike ended after the court stayed his sacking July 7, 2006.

Ramadoss later filed an appeal in the Supreme Court against the restraint imposed by the high court on the removal of Venugopal.

On July 25, the government offered to withdraw its order sacking Venugopal but decided to raise charges against him in court.

During this controversy some patients at AIIMS reportedly died due to lack of treatment.