Delhi High Court

Delhi High Court Takes Action: ₹50K Fine for Insurance Company’s Denied Claim of Breast Cancer Patient

In the case of Garima Singh v New India Assurance Co Ltd & Ors, the Delhi High Court imposed a ₹50,000 fine on the Central government-owned insurance company for causing distress to a breast cancer patient by wrongfully denying her claim. Justice Subramonium Prasad clarified that the mediclaim policy’s sub-limit of ₹2 lakh for immunotherapy does not apply to Chemo-immunotherapy, a combined treatment method.

Court Intervention

The Court emphasized that even if there was ambiguity, the principle of contra proferentem would favor the petitioner, entitling her to the full claimed amount. Consequently, the Court directed the insurance company to settle Garima Singh’s claim within four weeks. Given the undue harassment suffered by the petitioner, the Court ordered the insurance company to pay her ₹50,000 as costs within the same timeframe.

Singh approached the Court after being denied her insurance claim by New India Assurance Company. Despite having a policy with a cover of ₹44.5 lakhs, her claim for stage-IV breast cancer treatment, including Chemo-immunotherapy, was rejected. The insurer cited a ₹2 lakh sub-limit for immunotherapy treatments. Singh sought ₹11 lakh for her treatment costs.

Ombudsman’s Directive

Upon Singh’s complaint, the Insurance Ombudsman instructed the insurer to honor the claim, emphasizing the critical nature of the treatment. However, Singh alleged non-compliance by the insurer and moved the High Court. The insurance company informed the Court that over ₹37 lakhs had already been disbursed to Singh.

Court’s Ruling

The insurance company argued that the Ombudsman’s award only requires payment according to the policy terms, which limit immunotherapy claims to ₹2 lakh. However, the Court dismissed this argument, emphasizing that the ₹37 lakh already paid to the petitioner was irrelevant to the current claim. The Court ruled that the insurer must honor the claimed amount in compliance with the Ombudsman’s award, both in letter and spirit.

Read More: Supreme CourtDelhi High CourtStates High CourtOther CourtsInternational

Payal Singh

Recent Posts

Centre Opposes Ex-Judges Panel To Monitor Stubble Burning In SC

The Centre on Friday opposed a proposal in the Supreme Court to form a committee…

14 hours ago

“It’s A Celebration For Us”: Delhi HC Bar Association Felicitates CJI Sanjiv Khanna

The Delhi High Court Bar Association on Friday honored Chief Justice of India Justice Sanjiv…

14 hours ago

International Criminal Court Issues Arrest Warrant For Israeli PM Netanyahu

The International Criminal Court has recently issued arrest warrants for Israeli Prime Minister Benjamin Netanyahu,…

15 hours ago

Cal HC Stays Demolition Of Illegal Constructions In WB’s Mandarmoni

The Calcutta High Court on Friday granted an interim stay on the demolition of alleged…

15 hours ago

SC To Pass Order On Pleas To Efface Words ‘Secular’, ‘Socialist’ From Preamble

The Supreme Court on Friday announced that it would deliver its order on November 25…

16 hours ago

Air Pollution: SC Questions Delhi Govt On Truck Entry Amid GRAP-4 Restrictions

The Supreme Court raised concerns on Friday about the "drastic" consequences of the GRAP Stage…

16 hours ago