Man receives Rs. 2.5 lakh in mediclaim after 12-year legal battle

Firoz Rabadi, 50, underwent surgery in 2010 and received Rs 2.5-lakh claim from insurance company . Insurance company denied the argument, claiming that the invoice submitted did not carry a revenue stamp on it .

SURAT: A 50-year-old man had to fight for 12 years to get a Rs 2.5-lakh claim, which was rejected by the insurance company because it was paid in cash to the hospital.Firoz Rabadi, the complainant, underwent surgery in 2010.There is no universal law that a patient cannot pay a doctor in cash, according to the State Consumer Dispute Resolution Commission.The insurance company denied the argument, claiming that the invoice submitted did not carry a revenue stamp on it.

It cannot be said that the complainant had received it merely because the terms and conditions were attached.According to the commission, it will only be accepted if the changes were explicitly indicated.Since undergoing surgery in 2010, a Sagrampura resident had to fight for 12 years to recover a Rs 2.5 lakh claim from an insurance company he paid in cash to the hospital.The District Consumer Dispute Redressal Forum, Surat, rejected the complainants' argument in 2015.

The commission's judiciary members, M J Mehta and R N Mehta, finally issued an order in his favour directing New India Assurance Co Ltd to pay him the claim amount.There is no generalized rule that a patient should not pay a doctor in cash.But in this case, it was a term in the policy deal.According to Desai, the term was introduced later during re-insurance rather than when the policy was first bought.

Rabadi made the hospital payment in cash and the receipt he had provided did not have a revenue stamp on it, according to the insurer.According to the insurance company's counsel, it was stated in the clause that cash payments of more than Rs 10,000 would not be accepted for claims.It can be assumed that the complainant accepted the package merely by mentioning that the terms and conditions are attached.It will only be accepted if the changes were specifically requested.

Rabadi had undergone disc prolapse surgery and was discharged from the hospital in July 2010.The doctor requested payment of Rs 2.5 lakh in cash for the complainant just a few hours before the procedure, which the patient had to arrange somehow by borrowing.Although the Surat forum later dismissed the case by asking if the doctor paid taxes on the money received, Desai said that the commission was in the issuer's hands.