Winning Bizness Desk

Mumbai. There has been good news for the patients who want medical claims but they have to get themselves admitted in hospital for at least 24 hours. Now a person can claim insurance even without being admitted to the hospital. Even if someone has been admitted to the hospital for less than 24 hours, he has the right to claim insurance. Vadodara Consumer Forum of Gujarat gave this order on the complaint of the person. The forum said while ordering the insurance company to pay the resident Rameshchandra Joshi immediately. Joshi's claim was rejected by the insurance company. After which Joshi filed a complaint against National Insurance Company Limited in August 2017. Joshi's wife was diagnosed with dermatomyositis in 2016. After this he was admitted to Lifecare Institute of Medical Science and Research Center in Ahmedabad. Where Joshi's wife was discharged on the next day of treatment.

Patients are treated in less time

The Vadodara Consumer Disputes Redressal Commission (Additional) observed that with the new technology, sometimes patients are treated in less time. At the same time, many times treatment is done even without being admitted to the hospital. It was said on behalf of the forum that 'if the patient is not admitted or is treated in less time after admission due to new techniques. On this, the insurance company cannot reject the claim by saying that the patient was not admitted.

Company had firstly denied claim

Joshi had filed an appeal with the insurance company for a claim of Rs.44,468. But the company rejected it citing section 3.15. The company argued that he was not admitted continuously for 24 hours as per the policy rule. He produced all the documents before the Consumer Forum and stated that the wife was admitted on November 24, 2016 at 5.38 pm and was discharged on November 25, 2016 at 6.30 pm. Joshi said that this time was more than 24 hours.