Hyderabad: Star Health and Allied Insurance were asked to pay an amount of Rs 8.24 to one of its policyholders after the latter was forced to pay for his surgery in spite of having a cover. The District Consumer Disputes Redressal Commission (CDRC), Hyderabad-3, on October 3 directed the company to return the entire amount with 9% interest per annum from when the complaint was filed.
Mohd Habeeb Ahmed, 73 years, a Hyderabad resident, who availed a policy from Star Health and Allied Insurance, underwent a bypass surgery at Star hospital in March 2021. The hospital billed him Rs 8.24 lakh for the surgery and also added additional hospital charges. The patient however had to pay for the entire operation himself, as the company rejected his claim in spite of having a policy.
Aggrieved over the issue, Habeeb then filed a complaint against Star Health (hospital) and Allied insurance.
The insurance company however denied all the claims by Habeeb asked for dismissal of the case. They admitted that Habib had availed insurance from 2016 to 2021 earlier as per the policy schedule, and said that the insurance policy “is subject to conditions, clauses, warranties, exclusions etc.,” with regard to his claims.
After hearing the arguments from both sides, the commission directed the insurance company to refund Rs 8,24,731 along with 9% interest per annum to the complainant. The consumer commission further directed them to pay Rs 50,000 to to Habeeb as compensation towards “mental agony”. An additional sum of Rs 10,000 was also added as costs, al fo which which were to be paid within 45 days.
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