₹2L of ₹4L claim paid by Star Health; why family won
A dispute over a health insurance claim arose in a case involving Star Health and Allied Insurance Company Ltd. The insurer paid only Rs 2 lakh of a Rs 4.28 lakh medical bill incurred by the insured's family for a cerebrovascular accident (CVA) treatment. The Additional District Consumer Disputes Redressal Commission, Belagavi, found fault with Star Health's claim that a disease-specific sub-limit of Rs 2 lakh applied to the treatment.
The insurer was ordered to pay the remaining balance of Rs 2,28,308, along with interest, compensation for mental anguish, and litigation costs. The commission's decision emphasized that when renewing a health insurance policy and increasing the sum insured, policyholders should carefully review whether any sub-limits or restrictions have changed or been carried over to the renewed policy.
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