Kannur District Commission Holds Star Health And Allied Insurance Co. Liable For Wrongful Repudiation Of Medical Claim

The District Consumer Disputes Redressal Forum, Kannur (Kerala), found Star Health and Allied Insurance Company liable for deficiency in services due to wrongfully repudiating a genuine insurance claim. \r

The complaint arose when the Insurance Company denied coverage for treatment related to 'pituitary macroadenoma Acromegaly,' citing non-disclosure of a pre-existing condition. \r

However, the Forum observed that the disease was diagnosed only after the two-year claim-free period specified in the policy, and medical evidence presented during proceedings did not support the Insurance Company's assertion of pre-existing condition. \r

Therefore, the Forum directed the Insurance Company to reimburse the hospital bill of Rs. 7,02,420/- to the Complainant with 4% interest per annum. Additionally, compensation of Rs. 25,000/- and costs of Rs. 5,000/- were awarded to the Complainant.