20-year-old TB history can’t void Covid insurance claim: Consumer forum

Vadodara: She spent a harrowing time in the hospital while undergoing treatment for Covid during the pandemic in Vadodara in Nov 2020. When her husband Mukesh Shah filed an insurance claim of Rs 1.41 lakh, the insurer rejected it by arguing that she had suffered from tuberculosis 20 years ago which wasn’t declared while buying the policy. The Vadodara consumer forum, though, ordered the insurance firm to pay the claim amount to Shah.According to the case details, Shah had bought an insurance policy of Rs 5 lakh for himself and his wife from Future General India Insurance Company Ltd in 2020. Shah had even paid an extra premium as he was suffering from diabetes and hypertension and his wife also had diabetes.In Nov 2020, Shah’s wife was admitted to a hospital for five days for treatment of Covid infection. Shah then filed a claim of Rs 1.41 lakhs but the insurer rejected it in Dec 2020 on the grounds that the patient had suffered from pulmonary tuberculosis which was not disclosed to the insurance firm. Shah filed a complaint with the Vadodara District Consumer Disputes Redressal Commission (additional) in Feb 2021.The insurance firm told the consumer commission that the patient had TB 20 years ago and it was not disclosed in the proposal form. The consumer forum observed that it wasn’t proved if the patient wasn’t asked if she had suffered from some disease 20 years ago, when she was young. If the patient was asked then she would have definitely mentioned TB as they had paid a loading premium, it added.“Even if it is believed that the patient had TB 20 years ago but the opponent hasn’t proved that she contracted Corona due to TB. The doctor’s certificate given to the patient says that the Covid disease didn’t occur due to the previous TB," the forum observed. The consumer commission ordered the insurance firm to pay Rs 1.41 lakh to the complainant with Rs 5,000 each for legal cost and mental agony.