New Delhi: The Consumer Affairs Ministry has taken a significant step to address a crucial concern raised by the Chief of the National Consumer Commission.
In response to the issue highlighted, the ministry has declared its intention to engage with the Insurance Regulatory and Development Authority of India (IRDAI) and the Department of Financial Services (DFS), according to a report by The Times of India.
The matter in question revolves around the denial of medical claims by insurance companies when policyholders undergo surgery or treatment without being hospitalized for a minimum of 24 hours.
This condition has become a point of contention, prompting Justice Amreshwar Prasap Sahi, the National Consumer Disputes Redressal Commission (NCDRC) president, to advocate for its reconsideration.
Speaking at an event commemorating National Consumer Rights Day, Justice Sahi emphasized the need to reevaluate this clause in light of advancements in medical procedures.
He pointed out that modern treatments and surgeries often take less than 24 hours, rendering the existing condition obsolete.
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Justice Sahi praised the innovative approach adopted by some district forums that ordered the payment of claims even if the hospitalization duration was slightly less than 24 hours. He underscored the importance of making insurance companies aware of these changes in medical practices.
Union Consumer Affairs Secretary Rohit Kumar Singh affirmed the ministry’s commitment to consumer interests and announced plans to engage with IRDAI and DFS to find a suitable solution. Singh stated, “In the interest of consumers, we will take it up with IRDA and DFS to find a way out. Our focus is on finding solutions and reducing disputes.”
Justice Sahi commended the efforts of district consumer commissions in Punjab and Kerala for passing “landmark orders” related to medical insurance claims.
He cited an instance where the Ferozpur District Consumer Commission held an insurance company accountable for wrongly rejecting a medical claim based on hospitalization lasting less than 24 hours.
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While acknowledging the increased efficiency in complaint resolution, Justice Sahi highlighted the challenges in executing these orders. He emphasized the need for a standardized scheme for execution to enhance the effectiveness of consumer justice.
