Treatment Protocols Are a Doctor’s Domain, not Insurance companies

Newz Desk, Durgapur: For Dadri resident Nitu Nagar, the Covid ordeal did not end at the hospital. Her husband Ajay, admitted in January 2022 with high fever and difficulty in breathing, recovered — but the family was left battling their insurer, Star Health, which refused to settle the hospital expenses.

After nearly three years of pursuing the matter, Nagar finally received justice. The Ghaziabad District Consumer Commission has ruled that insurance companies cannot override a doctor’s clinical judgment, especially in emergency cases. It directed Star Health to reimburse ₹49,423 with interest and pay litigation costs.

The insurer had argued that Ajay was “asymptomatic” and should have stayed in home isolation — a claim the commission found baseless, noting that Star Health had no authority to decide the mode of treatment.

The family had initially sought cashless approval and was assured quick clearance, only to have the claim rejected later. After repeated attempts failed, Nagar issued a legal notice and moved the commission in September 2022.

Image courtesy@internet

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