A recent District Consumer Redressal Commission II ruling has brought good news for patients and their families. The commission ruled that lifestyle diseases like diabetes and hypertension cannot be considered pre-existing conditions and cannot be used as grounds to reject insurance claims. This decision ensures that insurance companies cannot unfairly deny claims for patients suffering from these common conditions.
Understanding the Case
A complaint was filed after an insurance company rejected a home loan insurance policy claim. The reason for rejection? The deceased policyholder had diabetes and hypertension but had not disclosed it when purchasing the policy. However, the actual cause of death was a stroke, not these conditions.
The commission ruled in favor of the complainant, stating that:
✅ Diabetes and hypertension are lifestyle diseases, not pre-existing conditions
✅ Non-disclosure of these conditions does not disqualify an insurance claim
✅ The insurance company must pay the insured amount of ₹45,00,000
Why Is This Decision Important?
Millions of people in India suffer from diabetes and hypertension—common conditions that can be managed with medication and lifestyle changes. Many patients worry that having these conditions may prevent them from getting health or life insurance. This ruling confirms that:
✔ Insurance companies cannot treat lifestyle diseases as pre-existing conditions
✔ Patients with diabetes and hypertension are still eligible for claims
✔ Medical claims should be judged based on actual cause of death or illness
What Doctors & Patients Should Know
🔹 Full disclosure is always recommended when buying insurance, but this ruling protects patients from unfair claim rejections.
🔹 Doctors should educate patients that having diabetes or hypertension should not stop them from securing insurance coverage.
🔹 Patients should know their rights and seek legal help if an insurance company wrongfully denies a claim.
Final Thoughts
This landmark ruling is a win for patients and their families, ensuring fair treatment in health and life insurance claims. Diabetes and hypertension are manageable conditions, not life-threatening diseases, and should not be used as an excuse to deny rightful insurance claims.
📢 Have you or someone you know faced insurance claim issues due to a medical condition? Share your thoughts in the comments!
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