health insurance

An increase in health insurance disputes seen post COVID: Reports

Health Insurance News

Indore: Despite the fact that there were more consumer cases involving health insurance filed, a decline of 57.71% in litigation was seen. This was reported across two district consumer dispute redressal commissions (DCDRC) from the year before the pandemic.

From January 1 to November 19 of this year, 126 new cases were filed in the district’s two DCDRCs, according to reports from the DCDRC’s office. As per records, 298 new cases were filed during the same time in the year before the pandemic in 2019.

Despite the fact that consumer cases have decreased, the nature of cases in DCDRCs has significantly changed. Since the COVID-19 pandemic began on March 23, 2020, many health insurance cases have been brought before the forum.

Shailendra Singh, a member of DCDRC-2, told TOI: “After COVID-19 struck the district, more and more lawsuits involving health insurance were filed with DCDRC. However, most of the time, insurance companies have denied claims due to a lack of documentation.

When such cases are brought before the DCDRC, we direct the insurance companies to give them time to file those documents before deciding on claims. This is how the problems are solved, according to Singh.

Because insurance companies don’t follow the principle of natural justice by giving applicants enough time to submit supporting documentation before rejecting claims, Singh claimed that more insurance claims are being filed.

If this is done, Singh continued, “the number of cases brought before the forum will further decline.”

Around 56 and 224 new cases were filed in 2021 and 2020 (from January 1 to November 19), respectively. Due to the DCDRCs’ continued closure due to the Covid -19-induced lockdown, few new cases were filed in 2020.