{"id":40580,"date":"2015-12-23T06:08:58","date_gmt":"2015-12-23T00:38:58","guid":{"rendered":"https:\/\/www.legalindia.com\/news\/?p=40580"},"modified":"2015-12-23T06:08:58","modified_gmt":"2015-12-23T00:38:58","slug":"health-insurance-frm-asked-to-pay-rs-3-lk-to-claimant","status":"publish","type":"post","link":"https:\/\/www.legalindia.com\/news\/health-insurance-frm-asked-to-pay-rs-3-lk-to-claimant","title":{"rendered":"Health insurance frm asked to pay Rs 3 lk to claimant"},"content":{"rendered":"<figure id=\"attachment_37471\" aria-describedby=\"caption-attachment-37471\" style=\"width: 240px\" class=\"wp-caption alignright\"><a href=\"https:\/\/i0.wp.com\/www.legalindia.com\/news\/wp-content\/uploads\/sites\/2\/2015\/04\/Right-to-Public-Service-Act.png?ssl=1\" rel=\"attachment wp-att-37471\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"37471\" data-permalink=\"https:\/\/www.legalindia.com\/news\/no-legislation-to-enact-right-to-public-service-act-tn-govt-to-hc\/right-to-public-service-act\" data-orig-file=\"https:\/\/i0.wp.com\/www.legalindia.com\/news\/wp-content\/uploads\/sites\/2\/2015\/04\/Right-to-Public-Service-Act.png?fit=240%2C205&amp;ssl=1\" data-orig-size=\"240,205\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Right to Public Service Act\" data-image-description=\"&lt;p&gt;Right to Public Service Act&lt;\/p&gt;\n\" data-image-caption=\"&lt;p&gt;Right to Public Service Act&lt;\/p&gt;\n\" data-medium-file=\"https:\/\/i0.wp.com\/www.legalindia.com\/news\/wp-content\/uploads\/sites\/2\/2015\/04\/Right-to-Public-Service-Act.png?fit=240%2C205&amp;ssl=1\" data-large-file=\"https:\/\/i0.wp.com\/www.legalindia.com\/news\/wp-content\/uploads\/sites\/2\/2015\/04\/Right-to-Public-Service-Act.png?fit=240%2C205&amp;ssl=1\" class=\"wp-image-37471 size-full\" src=\"https:\/\/i0.wp.com\/www.legalindia.com\/news\/wp-content\/uploads\/sites\/2\/2015\/04\/Right-to-Public-Service-Act.png?resize=240%2C205&#038;ssl=1\" alt=\"Health insurance frm asked to pay Rs 3 lk to claimant\" width=\"240\" height=\"205\" \/><\/a><figcaption id=\"caption-attachment-37471\" class=\"wp-caption-text\">Health insurance frm asked to pay Rs 3 lk to claimant<\/figcaption><\/figure>\n<p>A consumer\u00a0court of\u00a0Thane\u00a0has ordered a health insurance\u00a0company 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.<\/p>\n<p>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.<\/p>\n<p>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.<\/p>\n<p>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.<\/p>\n<p>Mohite then approached the forum seeking a claim of Rs 3 lakh and Rs 50,000 as compensation.<\/p>\n<p>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.<\/p>\n<p>Forum president Shena Mhatre and members Madhuri Vishwarupe and ND Kadam gave the definition provided by a court ruling in a case that &#8220;pre-existing disease is one for which the insured should have undergone hospitalisation or undergone long treatment or operation.&#8221;<\/p>\n<p>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.<\/p>\n<p>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.<\/p>\n<p>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.<\/p>\n<p>( Source &#8211; PTI )<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A consumer\u00a0court of\u00a0Thane\u00a0has ordered a health insurance\u00a0company 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 [&hellip;]<\/p>\n","protected":false},"author":38299,"featured_media":37471,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[86],"tags":[5933,146,31987,2553,2310,35062,3411,117,80],"class_list":["post-40580","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-consumer-law-news","tag-consumer-court","tag-court","tag-featured","tag-firm","tag-health","tag-health-insurance-frm-asked-to-pay-rs-3-lk-to-claimant","tag-insurance","tag-law","tag-legal-news"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Health insurance frm asked to pay Rs 3 lk to claimant - Legal News India - Supreme Court &amp; High Court Updates<\/title>\n<meta name=\"description\" content=\"A consumer\u00a0court of\u00a0Thane\u00a0has ordered a health insurance\u00a0company to pay Rs 3 lakhs to a claimant as it failed to prove that his wife was suffering from a - Get the latest legal news from the Supreme Court, High Courts, and government. 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Thane District Consumer Rederessal Forum president Sneha Mhatre and member Madhuri Vishwarupe said the insurance firm was deficient in services as\u2026","rel":"","context":"In &quot;Top Law News&quot;","block_context":{"text":"Top Law News","link":"https:\/\/www.legalindia.com\/news\/category\/top-law-news"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.legalindia.com\/news\/wp-content\/uploads\/sites\/2\/2018\/02\/Consumer-court.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":34571,"url":"https:\/\/www.legalindia.com\/news\/insurer-asked-pay-rs-1l-compensation-client","url_meta":{"origin":40580,"position":1},"title":"Insurer asked to pay Rs 1L compensation to client","author":"Legal India Admin","date":"August 4, 2014","format":false,"excerpt":"Accusing an insurance company of deficiency in service, the Thane District Consumer Redressel Forum has directed the firm and a claim settler to pay Rs 1 lakh compensation to a complainant. President of the forum Umesh Jhavalalikar and member N D Kadam, in their order issued recently, also asked the\u2026","rel":"","context":"In &quot;Top Law News&quot;","block_context":{"text":"Top Law News","link":"https:\/\/www.legalindia.com\/news\/category\/top-law-news"},"img":{"alt_text":"1L compensation","src":"https:\/\/i0.wp.com\/www.legalindia.in\/news\/wp-content\/uploads\/2014\/08\/1L-compensation.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":34300,"url":"https:\/\/www.legalindia.com\/news\/insurance-co-asked-rs-2-5-lakh-thane-man","url_meta":{"origin":40580,"position":2},"title":"Insurance co asked Rs 2.5 lakh to Thane man","author":"Legal India Admin","date":"July 19, 2014","format":false,"excerpt":"Holding that ICICI Lombard General Insurance was deficient in its services while dealing with a claim, the district consumer forum here has asked the company to pay a compensation of Rs 2.50 lakh to a policy holder. In their recent ruling, Thane District Consumer Redressal Forum President Umesh Jhavalikar and\u2026","rel":"","context":"In &quot;Top Law News&quot;","block_context":{"text":"Top Law News","link":"https:\/\/www.legalindia.com\/news\/category\/top-law-news"},"img":{"alt_text":"justice","src":"https:\/\/i0.wp.com\/www.legalindia.in\/news\/wp-content\/uploads\/2014\/06\/justice.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":40003,"url":"https:\/\/www.legalindia.com\/news\/kin-of-farmer-killed-in-road-mishap-get-rs-9-90-lakh","url_meta":{"origin":40580,"position":3},"title":"Kin of farmer killed in road mishap get Rs 9.90 lakh","author":"Legal India News","date":"November 23, 2015","format":false,"excerpt":"The Thane Motor Accident Claims Tribunal (MACT) has asked New India Assurance Company to pay Rs 9.90 lakh compensation to the family of a farmer who died in a mishap in 2012, and recover the amount from the owner of the offending vehicle. The claimant, Sangeeta Vilas Kirkire (28), told\u2026","rel":"","context":"In &quot;Consumer Law News&quot;","block_context":{"text":"Consumer Law News","link":"https:\/\/www.legalindia.com\/news\/category\/consumer-law-news"},"img":{"alt_text":"Kin of farmer killed in road mishap get Rs 9.90 lakh","src":"https:\/\/i0.wp.com\/www.legalindia.com\/news\/wp-content\/uploads\/sites\/2\/2015\/06\/Motor-Accident-Claims-Tribunal.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":27208,"url":"https:\/\/www.legalindia.com\/news\/hc-raises-award-from-rs-10-lakh-to-rs-41-lakh-in-accident-case","url_meta":{"origin":40580,"position":4},"title":"HC raises award from Rs 10 lakh to Rs 41 lakh in accident case","author":"Legal India Admin","date":"March 14, 2013","format":false,"excerpt":"Considering that serious injuries in a bus accident had rendered a businessman of nearby Thane permanently disabled and paraplegic 7 years ago, the Bombay High Court has enhanced compensation awarded to him by Motor Accident Claims Tribunal from Rs 10.61 lakh to Rs 41.31 lakh. \"The right to life in\u2026","rel":"","context":"In &quot;Top Law News&quot;","block_context":{"text":"Top Law News","link":"https:\/\/www.legalindia.com\/news\/category\/top-law-news"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":46404,"url":"https:\/\/www.legalindia.com\/news\/kin-man-killed-mishap-get-rs-21-8-lakh-compensation","url_meta":{"origin":40580,"position":5},"title":"Kin of man killed in mishap get Rs 21.8 lakh compensation","author":"Legal India News","date":"January 3, 2017","format":false,"excerpt":"The UP-based family of a man, who died in a mishap here in 2011, has been awarded Rs 21.81 lakh compensation by the Thane Motor Accident Claims Tribunal (MACT). 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