Indian court rules insurer must pay claimant despite tobacco use

Indian court rules insurer must pay claimant despite tobacco use | Insurance Business

Indian court rules insurer must pay claimant despite tobacco use

A consumer court in Ahmedabad, India has ordered two insurers to pay for a policyholder’s claim for oral cancer treatment, even if the claimant was a tobacco user.

The court observed that using tobacco cannot be considered the only cause of oral cancer, a report by Times of India said. The claimant, Kanaiyalal Modi, had been smoking and chewing tobacco for the past four years.

The two insurers, New India Assurance Co. and Health India TPA Services, were ordered to reimburse Modi the INR112,000 (around US$1,600) he paid for oral cancer surgery in 2014. The court also ruled that the insurers’ rejection of Modi’s initial claim due to his use of tobacco was improper. They were also ordered to pay Modi an additional INR3,000 for legal costs and damages.

According to Modi, the certificate from his doctor indicated that he was indeed a tobacco user, but it also stated that tobacco use cannot be considered the sole reason for cancer and that the “exact reason for oral cancer cannot be determined.” The court noted that in Modi’s case, cancer was not a pre-existing disease, as he had bought the health insurance policy in 2003.