Insurer treated typhoid as ‘pre-existing disease’

Vadodara: If an insurance company is to be believed, typhoid — an illness that is typically cured within a few weeks — can be treated as a "pre-existing" disease that a patient continues to carry for over a year.In a peculiar case, this was cited as the reason to reject a mediclaim filed by an 18-year-old youth from Panchmahal district. However, the youth moved the consumer commission, which ruled in his favour and directed the company to pay to settle the mediclaim amount of Rs 43,964.Hardik Rana (18), a resident of Kalol in Panchmahal district, moved the consumer forum after his mediclaim claim was rejected in 2023. He purchased the policy with Rs 5 lakh coverage on Aug 13, 2022, and valid up to Aug 12, 2025.On Aug 25, 2023, Rana fell ill and was admitted to a hospital where doctors diagnosed him with enteric fever. He remained hospitalised till Aug 31, 2023. The expenses incurred towards hospitalisation, medical tests and medicines amounted to Rs 43,964. Following the treatment, Rana submitted a reimbursement claim along with all relevant medical documents to the insurance company.However, the company rejected the claim, stating that Rana's illness was a pre-existing disease. It further alleged that there were discrepancies in the information and declarations he submitted. Advocate Rudresh Trivedi, who represented Rana, argued that several policyholders face similar rejections on such vague grounds. "It appears that insurance companies often rely on a standard set of arguments while denying claims," he said.According to the order passed by the commission, the insurer failed to specify the nature of the discrepancies or explain which declarations were allegedly incorrect.It also ordered the company to pay Rs 2,000 towards the mental agony caused to the complainant and another Rs 2,000 towards litigation expenses.
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