Jayanagar 3rd Block East Bangalore-560011, Karnataka India
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Showing 8 case studies in Health Insurance
₹10 Lakh Health Claim Rejected Over Smoking Allegation
An insurer rejected a ₹10 lakh aneurysm treatment claim alleging chronic smoking, but the Coimbatore consumer commission found the allegation unsupported by evidence and ordered payment with compensation and costs.
₹48,251 Health Claim Rejected Over Google Timeline
An insurer rejected a ₹48,251 hospitalisation claim partly because Google Timeline did not show the hospital, but the consumer forum relied on medical records and ordered payment with 8% interest.
₹2.85 Lakh Cancer Claim Rejected Over Two Injections
An insurer refused ₹2.85 lakh for cancer injections because no hospitalisation was needed, but the Karnataka High Court upheld the reimbursement and imposed ₹50,000 costs.
₹58,729 Health Insurance Claim Rejection Overturned
A ₹58,729 health insurance claim was rejected as medically unnecessary, but the Kangra Consumer Commission overturned the decision and ordered reimbursement with interest and compensation.
₹1.08 Crore Health Claim: Supreme Court Victory
A disclosed Type-II diabetic suffered a cardiac episode abroad and faced a ₹1.08 crore claim rejection over alleged pre-existing conditions — the Supreme Court ruled the repudiation was illegal.
Denied Abroad, Justice Won
A ₹88 lakh overseas cancer treatment claim was denied, then a consumer commission ordered ₹66.5 lakh paid.
No Disease Proof, ₹20L Ordered
Health insurance case involving claim denial and subsequent court-ordered compensation.
AI Cut ₹1.6 Crore Hospital Bill
Technology-assisted fraud detection in healthcare insurance claims.
