The Gujarat state consumer commission gave judgement, while hearing the case of a housewife aged 59 years from ahmedabad held that if a diabetic person is diagnosied with heart problems subsequent to taking a policy , the insurance company cannot reject the claim on the ground of suppression of material fact about preexisting disease. A diabetic cannot be refused claim for heart ailments if the policy was taken prior to diagnosis The commission denied the insurance company's claim that because of diabetes the customer suffered from heart problems. Moreover the commission held that a diabetic patient can lead a normal life as usual if the same is kept under control through proper care and medification.
The insurance company failed to prove relation between diabetes and the blockage in her(customer) artery. The commission asked the company to pay the medical expenses of Rs 39.90 lakh at an interest of 9%. the company was directed to pay rs 7000 for the mental agony caused to the patient and Rs 3000 towards the complain procedure.
The insurance company failed to prove relation between diabetes and the blockage in her(customer) artery. The commission asked the company to pay the medical expenses of Rs 39.90 lakh at an interest of 9%. the company was directed to pay rs 7000 for the mental agony caused to the patient and Rs 3000 towards the complain procedure.
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