Daijiworld Media Network – Udupi (JD)

Udupi, June 23: The Udupi District Consumer Disputes Redressal Commission has directed Star Health and Allied Insurance Company to pay Rs 40,178 with 10% annual interest to a policyholder for unfair trade practices and deficiency in service.

The complainant, Vikram, a resident of Bailakere in Tenkanidiyur village, held a long-standing health insurance policy with the company. On May 22, 2024, he was admitted to a private hospital in Udupi after developing swelling on the left side of his groin. Although the treatment cost was higher, the company reimbursed only Rs 41,170, denying Rs 30,178 on the grounds of a “pre-existing disease” — a claim not supported by the policy documents.

Aggrieved by the partial settlement, Vikram filed a complaint through his advocate before the District Consumer Forum. Upon reviewing the evidence, the commission ruled that the insurance company had failed to prove the presence of any pre-existing illness. It directed the company to pay the pending amount with 10% annual interest from May 25, 2024, until full payment is made.

Additionally, the commission awarded Rs 10,000 as compensation for mental agony and legal expenses, instructing that the total amount be paid within 30 days of receiving the order.

The verdict was delivered by commission president Sunil Timasareddy and member Sujata B Koralli. Advocate Vivekananda Mallya represented the complainant.