Dengue needs no hosp care, says insurer, gets pulled up

Vadodara: A disease like dengue, which can even turn fatal for patients, needs no hospitalization and can be cured by outpatient department (OPD) treatment. At least this is what a public sector insurer and third-party administrator (TPA) want patients to believe.
However, United India Insurance Company Ltd and MD India Healthcare TPA Pvt Ltd, earned the ire of consumer court in Vadodara for this brazen medical advice to reject the claim of a Navapura citizen whose teenage son was hospitalized for dengue. The insurer turned down the claim of Rs 13,783 put forward by Kirti Patel, whose son Manan, was admitted at BAPS Shastriji Maharaj Hospital in Atladara in November 2017.
Manan was diagnosed with dengue and bicytopenia, severe deficiency of erythrocytes, leukocytes and platelets in the blood. He was discharged after three days of hospitalization. But the companies said that both diseases could be cured with OPD treatment and needed no hospitalization.
After the company rejected the claim, Patel approached Vadodara District Consumer Disputes Redressal Forum to get back the money spent on medical treatment as well as compensation for mental harassment.
“During the hearing of the case too, the insurance company and TPA stuck to their contention that dengue and bicytopenia could be treated through OPD and there was no need for hospitalization. But Patel presented medical papers including the doctor’s opinion regarding the line of treatment to be given to cure dengue and bicytopenia,” said Jignesh Chauhan, Patel’s lawyer.
The forum presided by DY Malik rejected the insurance company and TPA’s arguments and came down heavily on the companies for the brazen medical advice. The court directed them to reimburse the entire medical expense along with 8% interest and Rs 2,500 as compensation.