The District Consumer Disputes Redressal Commission of Ernakulam has ordered an insurance company to pay an insured person an amount comprising a claim under the health policy issued by the company, compensation money and litigation costs.
Under the policy, people ill with COVID-19 are entitled to the reimbursement of medical expenses. However, when the plaintiff fell ill and was hospitalized, the insurance company refused to pay claiming that, since the medical records indicated good conditions, the hospitalization was meant to be for monitoring rather than for treatment.
The Commission, however, found that the petitioner was entitled to full reimbursement since he had fulfilled all the conditions laid out in the policy. Furthermore, the policy was specifically designed for people who contracted COVID-19. Therefore, the behaviour of the insurance company was not only a deficiency in service but also represented an unfair trade practice.