Anand Arora purchased health insurance cover of Rs 20 lakhs from Sunbeam Insurance Co. He ensured full disclosure of all existing medical conditions in the application.
Anand got severe jaundice in December 2009, and doctors advised hospitalization. His condition worsened and while testing, the doctors found a tumour on Anand’s back, which required surgery. The hospital treated the jaundice and surgically removed the tumor. Anand was extremely relieved to have health insurance when he saw the Rs eight lakh bill.
However, to his immense shock, Sunbeam refused to pay his bill. They said that Anand had failed to disclose the tumor when he purchased his policy. Despite the fact that it was detected only after hospitalization. Anand was forced to borrow money to pay the bill.
An outraged Anand filed a case in the Consumer Court. The case dragged on and took up a lot of Anand’s money, time, and energy. Finally, after six years, the Court awarded him Rs. 40 lakhs.
Unfortunately, Anand never lived to see the money. He died six months before the award.
Anand could have opted for ODR and the award would have happened in just a few months at a fraction of the cost.
Disclaimer: All characters and names are fictional. This is a public interest story