Justice Sachin Datta made the observation while directing United India Insurance Company Limited to release the balance amount to petitioner Reena Goel, whose Covid-19 hospitalisation claim was only partly reimbursed despite being within the insured coverage
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The Delhi High Court has ruled that a government circular issued during the COVID-19 pandemic, regulating hospital charges, cannot be construed as limiting the contractual obligations of insurance companies towards their policyholders, reported news agency ANI.
Justice Sachin Datta made the observation while directing United India Insurance Company Limited to release the balance amount to petitioner Reena Goel, whose Covid-19 hospitalisation claim was only partly reimbursed despite being within the insured coverage.
The non-release of the deficit amount is clearly unjustified and contrary to the clarification/s issued by IRDAI, the court noted.
The Court noted that the Delhi government's June 20, 2020, circular was intended to regulate the fees hospitals charged patients for Covid-19 treatment, rather than to reduce the reimbursement payable under insurance policies, reported ANI.
The position, the Court emphasised, had already been clarified by the Insurance Regulatory and Development Authority of India (IRDAI) through circulars issued in January and April 2021.
The petitioner was represented by advocates Rakshita Goyal, Sanyam Gupta, Aditya Goel, Anju Bhushan Gupta, and Ankita Chaudhary.
On the other side, Abhishek Nanda, Hrishika Rawat, and Sourabh Singh appeared for IRDAI (respondent no.2)
Goel had been admitted between December 4 and December 18, 2020, and incurred expenses of Rs 3,56,295. Although she was covered under a Rs3 lakh base policy and an additional Rs 3 lakh "Super Top Up Medicare Policy," the insurer reimbursed only Rs 1,75,340, citing the Delhi government's circular, reported ANI.
Finding the insurer's reliance on the circular unjustified, the Court held that the deficit payment was contrary to IRDAI's clarifications and the past conduct of the insurer in similar cases. It directed United India Insurance to settle the balance claim within four weeks.
Delhi HC takes exception to forest dept not permitting relocation of trees for bridge construction
Meanwhile, the Delhi High Court on Friday took exception to the city Forest Department's refusal to permit relocation of 21 trees for the construction of a foot-over-bridge (FCB) for the Rajputana Rifles to go to the parade ground in the Delhi Cantonment area, reported PTI.
The court said the Delhi Forest Department has been involved in this process since inception but for the first time it has taken this position on September 12 in its letter to the Delhi Cantonment Board that the area from where the trees are to be removed is deemed forest.
(With inputs from ANI and PTI)
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