KOCHI – In a significant ruling, the Ernakulam District Consumer Disputes Redressal Commission has imposed a fine on ManipalCigna Health Insurance Company, ordering it to pay ₹1,71,908 in compensation to a customer after unfairly denying a claim. The court determined that the company’s action constituted a “deficiency in service” and an “unfair trade practice.”
The case was brought forward by M.S. Prathapan, a resident of Aluva, against the insurance giant. Prathapan had purchased a Pro-Health insurance policy from ManipalCigna for the period between July 2023 and July 2024, which also covered his son.
In May 2024, his son was admitted to Renai Medicity Hospital in Kochi for treatment of a condition known as Bilateral Idiopathic Genu Valgum, where the knees touch each other. The total medical expenditure for the treatment amounted to ₹1,41,908.
After Prathapan submitted the claim, the insurance company rejected it, stating that he had failed to disclose a surgery his son underwent at the age of two on the proposal form. The complainant then approached the consumer court, challenging the company’s decision.
During the proceedings, the bench, presided over by D.B. Binu with members V. Ramachandran and T.N. Sreevidya, noted that ManipalCigna failed to produce any documents to support its claim of non-disclosure.
Based on this, the court ordered the company to pay the full treatment cost of ₹1,41,908. Additionally, it mandated a compensation of ₹25,000 for the service deficiency and ₹5,000 to cover legal costs. Advocate T.J. Lakshmana Iyer represented the complainant in court.
