Insurance company ordered to pay Rs 26,882 for wrongly rejecting dengue claim
A consumer commission in Punjab has ordered Star Health and Allied Insurance to pay a policyholder for a rejected dengue treatment claim. The commission ruled that the insurer could not deny the claim based on hospital record discrepancies that were outside the patient's control.
Why it matters
This ruling reinforces consumer protection rights against insurance companies that attempt to shift blame for administrative hospital errors onto policyholders.
NEW DELHI: A Punjab district consumer commission, in an order dated July 22, directed Star Health and Allied Insurance to reimburse a woman's medical claim after it rejected expenses incurred on her son's dengue treatment, citing alleged discrepancies in hospital records. The commission held that the insurer failed to verify those discrepancies with the hospital and wrongly rejected a genuine claim.Why was the dengue insurance claim rejected?According to the commission's order, the complainant had been covered under Star Health's Family Health Optima Insurance Plan since November 2020. During the policy period, her son was admitted to Dhaliwal Child Care Centre, Moga, with dengue on November 1, 2025, and remained hospitalised until November 6. As the insurer advised her not to wait for cashless approval, she paid the hospital bill of Rs 22,751 from her own pocket.After her son was discharged, she submitted a reimbursement claim.
Get smarter about the news
Sign up free for a feed built around what you actually care about, Dive Deeper research on any story, and the full text of every article.
Create free accountAlready have an account? Sign in