Insurer rejects ovarian cyst surgery claim over ‘waiting period’, woman wins Rs 2.6 lakh
A Kangra District Consumer Disputes Redressal Commission in Himachal Pradesh has ordered health insurer Niva Bupa to pay Rs 2.65 lakh to a woman who filed a complaint against the company's rejection of her ovarian cyst surgery claim. The insurer had cited a 36-month waiting period, claiming the woman's cyst was a pre-existing condition linked to a hysterectomy she underwent in 2020.
However, the commission ruled that the woman had maintained continuous health insurance coverage since 2019 and that the policy was ported to Niva Bupa without any break in coverage. The commission held that the rejection of the claim was a deficiency in service and an unfair trade practice.
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