By: Arvind Jadhav
Wrongful Claim Rejection
Mumbai: Aditya Birla Health Insurance Co. Ltd. has been accused of wrongful claim rejection by Mr. Manchanda, whose wife, Anita, underwent cataract surgery on February 19, 2024. Despite submitting a legitimate claim, the insurance company rejected it, citing a pre-existing condition that was not disclosed at the time of policy inception. However, Mr. Manchanda disputes this claim, stating that the cataract surgery was not related to the pre-existing condition mentioned by the insurance company. He also points out that the insurance policy specifically covers cataract surgery, making the rejection of the claim unlawful.
Dispute Over Policy Terms
This incident highlights the importance of carefully reviewing policy terms and seeking clarification before purchasing insurance products. The Insurance Ombudsman has ruled in favor of Mr. Manchanda, stating that Aditya Birla Health Insurance must settle the claim. However, the insurance company is refusing to pay interest compensation, as prescribed by Ombudsman rules.
A Larger Pattern of Wrongdoing
This case is not an isolated incident, with reportedly lakhs of similar cases where insurers are duping policyholders and wrongfully rejecting claims. Consumers have reported similar experiences with Aditya Birla Health Insurance, including claim rejections and lack of transparency.
A Warning to Consumers
This incident serves as a warning to consumers to be cautious when dealing with Aditya Birla Health Insurance. It is essential to carefully review policy terms, ask questions, and seek clarification before purchasing insurance products. Consumers must also be aware of their rights and take necessary action if they feel their claims are being wrongfully rejected.
