Bangalore District Commission Holds HDFC Ergo Health Insurance Co Liable For Wrongful Repudiation Of Claim Based On Unsubstantiated

The Bangalore District Consumer Disputes Redressal Commission held HDFC Ergo Health Insurance liable for wrongful repudiation of a claim based on an unsubstantiated pre-existing disease. The complainant, who switched to HDFC Ergo's policy, had their claim for medical expenses rejected due to alleged non-disclosure of pre-existing diabetes. The commission found the insurance company's rejection unjustified, as it failed to prove the complainant suppressed any medical history. The commission ordered the company to pay Rs. 5,99,272 for medical expenses, Rs. 20,000 for mental agony, and Rs. 10,000 for litigation costs.