Wrongful Repudiation Of Claim Based On Hyper Technical Grounds, Punjab State Commission Holds Star Health And Allied Insurance Liable

The State Consumer Disputes Redressal Commission, Punjab, led by Justice Daya Chaudhary and Simarjot Kaur, held Star Health and Allied Insurance Company accountable for wrongfully repudiating a genuine death claim. Mr. Rohit Thakur had a Medi Classic Insurance Policy with the company, covering him from 31.12.2016 to 30.12.2017. \r

He passed away in January 2018 after sudden medical issues, and his claim was denied citing a pre-existing chronic liver disease exclusion clause. The State Commission ruled that the Insurance Company failed to prove the deceased had a chronic condition before the policy period or that his condition wasn't emergent. \r

It criticized insurers for rejecting claims on technicalities, emphasizing insurance's role in safeguarding against unforeseen medical expenses. The Commission upheld the District Commission's decision, directing the insurer to pay Rs. 2,66,327/- with additional compensation and litigation expenses.