In a landmark judgment, a court in Gujarat ruled that a doctor was eligible to file for medical insurance for services provided in his hospital.
In June 2021, Dr. Indravadan Shah, the petitioner, filed a complaint with the Consumer Protection Court alleging Niva Bupa Insurance had failed to pay a claim. Shah said in his complaint that on October 31, 2020, he got infected with Covid-19.
“I was treated at my hospital and by my son till November 6, after which I incurred an expenditure of Rs 84,055. The insurance company rejected the claim.”
The claim was denied because the doctor received care from a family member in his hospital.
On November 11, Shah was ill and was kept in the hospital for five days again. Dr. Mosam, his son, provided him with care.
Shah then got in touch with the insurance company and explained his situation. He knew there was no clause in the policy documents that said that his relatives could not treat the insured and subsequently moved to the Consumer Court.
The Vadodara Consumer Disputes Redressal Commission Chairman ordered Shah to receive ₹ 1.69 lakh from the insurance company following the hearing.