Kerala Consumer Commission Orders Insurer to Pay Up

A Kerala consumer disputes redressal commission has ordered Star Health Insurance to compensate a customer for denied claims, ruling that the insurer failed to prove the concealment of a pre-existing condition. The commission found the rejection unjustified, demanding Rs 3,67,849 plus additional compensation.

The Ernakulam District Consumer Disputes Redressal Commission in Kerala has directed Star Health and Allied Insurance Company to pay Rs 3,67,849 to a policyholder. The directive follows the company's refusal to honor a claim, citing the purported nondisclosure of a pre-existing health condition.

The complainant, K P Rendeep from Aluva, underwent aortic valve replacement surgery and sought coverage under his Health Optima insurance policy, which he purchased in 2018. The company rebuffed his claim, arguing the condition predated the policy and was undisclosed, thus not covered in the initial two years.

The commission, however, led by Chairman D B Binu and members V Ramachandran and T N Sreevidhia, found insufficient evidence supporting the insurer's claims of nondisclosure. Additionally, the panel underscored the importance of trust between insurers and clients, ordering the company to also pay Rs 50,000 as compensation and Rs 10,000 for legal fees within a 30-day window.

(With inputs from agencies.)