Cancer Treatment Insurance Claim: Niva Bupa refused to give insurance claim for cancer treatment, but the consumer forum ordered to return Rs 4.27 lakh with interest. Know the whole matter.
A common family man, who took health insurance to secure the future of his wife and child, but when the need arose the most, the company backed out. The case is of Rajdhar Singh Yadav, a resident of Bina-Barha in Sagar district, who had taken a master policy from Niva Bupa Health Insurance (formerly Max Bupa).
Just a few months after taking the policy, in February 2024, Rajdhar Singh had pain in his neck and after examination, he was confirmed to have cancer. Doctors advised him to get treatment at Tata Memorial Hospital in Mumbai. The treatment lasted from April to August and cost Rs 747000.
The insurance company said ‘illness was hidden’, but there was no proof
When Rajdhar Singh sought a claim from the company, the insurance company rejected it. He claimed that the patient had hidden the information about his illness while taking the policy. But when the matter reached the consumer forum, the insurance company could not prove whether the patient had cancer at the time of the policy or he deliberately hid the information.
Forum said: Treatment is right, claim is valid – return the entire money with interest
While giving the verdict, Consumer Commission Chairman Rajkumar Koshta and member Anubha Verma directed the insurance company to return the amount of ₹4,27,407 with 6% annual interest. Along with this, orders were also given to pay ₹12,000 as additional compensation for deficiency in service and mental agony.
Lawyer’s arguments became the voice of justice
Advocate Pawan Nanhoria, who pleaded the case, said that Rajdhar Singh had taken a policy from 8 December 2023 to 7 December 2024. The company could neither prove the illness nor submit any investigation report at the time of the policy.
This case has become an example for millions of people who fall prey to the arbitrariness of insurance companies. This decision has strengthened the trust again.
