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Insurer's Absurd Demand Leads to Rs 14 Lakh Payout
17 Jul
Summary
- Manipal Cigna must pay over Rs 14.6 lakh for rejecting a claim.
- The insurer demanded impossible medical tests during CPR.
- Consumer commission called the rejection arbitrary and unreasonable.
A recent ruling by the North Delhi District Consumer Disputes Redressal Commission-I has compelled Manipal Cigna Health Insurance Company to pay more than Rs 14.6 lakh. This decision arose from the insurer's rejection of a claim following the death of Pankaj Srivastava in April 2021.
Srivastava was undergoing CPR when doctors attempted resuscitation. Manipal Cigna subsequently denied the claim, citing a lack of specific medical records like ECG or Troponin test results. The commission found this demand to be medically absurd and impossible to fulfill under such critical emergency conditions.
The commission strongly criticized the insurer's rejection as arbitrary and unreasonable, emphasizing that insurers cannot exploit technicalities to deny legitimate claims. The ruling underscores that policies should not be used to defeat valid claims based on impossible conditions during life-saving procedures.
In addition to policy benefits totaling Rs 12.10 lakh plus interest, Manipal Cigna was fined Rs 5 lakh for insensitive communication. The lender, Indiabulls Rural Finance, also faced a Rs 1 lakh penalty for initiating recovery proceedings while the claim was pending.
