Shortfall in Minimum Hospitalization Hours Cannot Defeat Claim
The complainant was admitted in hospital for covid treatment for 70 hours i.e. less than 2 hours of prescribed minimum period of 70 years. The claim was, therefore, repudiated.
It is common knowledge that advancement in medical science and
technology has reduced hospitalisation duration. Medical procedures that
needed prolonged hours earlier now can be accomplished in a much less time.
Hence shorter hospital stays do not imply less severity of illness, which fact
makes it axiomatically implied that technical conditions relating to duration
must be applied reasonably.
The insurer who
holds a dominant position is therefore expected to act fairly and in good faith in
matters concerned with health insurance.
The opposite parties’ unlawful denial of the complainant’s legitimate
claim might certainly have inflicted agony, hardship and financial loss on the
complainant. The opposite parties shall necessarily have to compensate the
complainant.
Judgment dated 27.3.2026 of the District Consumer Redressal Forum Trissur in Consumer Case No.159/2021 of Robin A.K. Vs. Managing Director, Star Health and Allied Insurance Co. Ltd and another
