Polio ploy fails, Max Bupa Health Insurance Co Ltd ordered to pay for broken leg

Ahmedabad: The Gujarat State Consumer Dispute Redressal Commission has ordered an insurance company to pay for the treatment of a woman who has had polio since birth.

The commission upheld the order passed by a Surat’s consumer forum to Max Bupa Health Insurance Co Ltd to pay Rekha Dungarani Rs 1.30 lakh with 8% interest from 2015. The company was also ordered to pay additional Rs 5,000 towards compensation for harassment and legal expenditure.

In this case, Dungarani fell down while riding pillion on a scooter in November 2015. She broke her right leg and was to be admitted to a hospital for four days. But her claim for treatment was refused by the insurance company on the grounds that she had polio, which she did not disclose in the policy proposal form.

The commission said that it is visible that the complainant had polio. Moreover, polio is not a disease which can be termed as a pre-existing condition.

Source: The Times of India