NO ‘PRE-EXISTING’ ESCAPE, PLEASE!
Health insurance consumers often find their claim rejected on the grounds of pre-existing disease. But now the onus is on the insurance companies to prove this much-abused ‘pre-existence’ clause. Recently, a consumer forum in Mumbai directed Royal Sundaram Alliance Insurance to pay the husband of a cancer survivor, a Thane resident, an insurance amount of Rs 1.50 lakh, along with a compensation of nearly Rs 1.45 lakh. The complaint was filed before the Additional Mumbai Suburban District Consumer Disputes Forum in October 2007. The complainant had taken the mediclaim policy for his family members and himself in October 2005. On March 20, 2006, his wife noticed a lump in her left breast. After undergoing a biopsy, she was diagnosed with cancer. Over the next few months, she underwent treatment at a city hospital, following which the husband filed a claim. However, the company repudiated it.