A.
Dear Client,
Pre-existing diseases (PED) are mostly expensive to treat as they are chronic in nature. Unfortunately, most health insurance plans cover pre-existing diseases after a waiting period of 2 to 4 years as people are already suffering from such diseases at the time of policy purchase. PED comprises both life-threatening illnesses to minor ailments that most commonly include thyroid, high blood pressure, diabetes, asthma, cholesterol, cancer, diabetes, etc. The NCDRC, the apex consumer commission, has held that an insurance claim cannot be denied on the mere presumption that a person might be suffering from a pre-existing disease. NCDRC said even if the insured person was suffering from a disease and did not know about it nor was taking any treatment for the same, the claim cannot be denied by an insurance company. So, a standalone prescription stating that the patient has been suffering from a disease for the last 7 years without any supporting medical evidence cannot be a ground for repudiation of the claim on the grounds of non-disclosure of PED by the insured when a policy is running for a period for 4 years. So, in the prevailing situation, you need to file a complaint against the Insurance Company for deficiency in service and unfair trade practice before the Dist. Consumer Commission, claiming the entire expenses of the treatment along with compensation for harassment. The Complaint should be filed within two years from the date of cause of action, i.e, from the date of repudiation of claim by the Insurance Company.
Posted On 08-Jan-2024
Share on
×