COIMBATORE: The Coimbatore District Consumer Dispute Redressal Commission has ordered an insurance company to settle Rs 5 lakh claim to a petitioner whose 38-year-old husband died during Covid-19 treatment in a private hospital in Coimbatore in 2021.
The petition was against the rejection of a medical insurance policy by a private insurer. The petitioner R Sathiya Devi is a resident of Ganapathy in Coimbatore. Her husband T Karthik was admitted to a private hospital after he fell ill due to Covid-19 on May 24, 2021.
Karthik, who was a businessman, had purchased Corona Kavach Policy from the Star Health Insurance by paying a premium of Rs 12,955. The policy had a claim value up to Rs 5 lakh from April 21, 2021 to April 22, 2022. He was treated in the private hospital till June 7, 2021 and shifted to another private hospital on the same date for Covid-19 treatment. However, he died without responding to the treatment on June 29.
His family had spent Rs 18.55 lakh for his treatment. Despite his wife Sathiya Devi sending all details to the Star Health Insurance seeking claim, the insurance firm refused to settle the sum Rs 5 lakh claiming that the patient was not eligible to claim the sum as he was admitted in hospital within 30 days from the availing of the policy.
Thereafter, the petitioner approached the consumer court in Coimbatore. The court found fault on the part of the insurance company and ordered to settle the policy sum Rs 5 lakh to the petitioner. Also, it directed to pay Rs 2 lakh for the petitioner’s mental agony.
K Parameshwari, a counsel of the petitioner said, “It was the second case, the court has ordered in favour of the petitioner. In the first case, the petitioner Senthikumar from Punjai Puliampatti was denied a Rs 2 lakh claim by the Star Health Insurance for his Covid 19 treatment. After the litigation, the insurance company was ordered to settle the policy claim. If any person who was denied policy claims for Covid treatment still they have time to file a case against the insurance company.”