Ahmedabad: The consumer court has held that mediclaim policy holders are not entitled to compensation if the illness is hereditary or if it is a genetic disorder.
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With this observation, the Consumer Disputes Redressal Commission, Gujarat State, quashed an order passed by the Consumer Disputes Redressal Forum, Rajkot district.
The forum had directed the Oriental Insurance Co Ltd last year to pay Rs 5 lakh with 6% interest along with Rs 6,000 towards compensation for physical and mental agony felt by Brijesh Solanki, a resident of Rajkot. Solanki underwent heart treatment in Mumbai's Breach Candy Hospital in October 2013, and a pacemaker was implanted for controlling his heartbeat.
Later, he was hospitalized in Sterling Hospital in Rajkot after he fell ill. He paid Rs 5.81 lakh towards treatment in these two hospitals.
When he claimed reimbursement of the bills, the insurance company objected by stating that the discharge reports from both hospitals revealed that Solanki had a history of muscular dystrophy.