Thread by @BimaPeBharosa

Why did it take a Gujarat resident 8 years to receive his son’s death claim?

A resident of Anand, Gujarat tragically lost his 22 year old son in 2013 to poor health. He went on to file a ₹5 Lakh death claim with his son’s life insurance policy, where he was the nominee.
(1/9)

However, his claim was denied by the insurance company on the grounds that the deceased was suffering from mental health issues for which he was hospitalized- a detail that had not been disclosed to the insurance company.
(2/9)

The problem was, insurance companies usually keep coverage for mental illness outside the purview of Health and Life Insurance policies. This has long been a point of contention, even though the 2017 Mental Healthcare Act expanded insurance coverage to mental illness.
(3/9)

According to the act, insurers are to treat policyholders making a claim for mental illness the same as they would someone seeking treatment for a physical ailment.

But as has been observed so far, these regulations have not been properly implemented.
(4/9)

Insurers are still wary of including mental health coverage because now the addressable claims have risen within the same premium, making it harder for them to profit.
(5/9)

Let’s come back to the case. After a failed complaint to the Anand district forum, the State Consumer Dispute Redressal Commission made a ruling in the beneficiary’s favor 8 years later.
(6/9)

They observed that there was no concrete proof of the deceased’s mental illness as the insurance company’s arguments were based on oral statements by the locals.
The burden of proof falls on the insurance company in such cases.
(7/9)

Since they were not able to provide an affidavit or a valid proof of any kind, the commission ordered them to pay the death claim along with 9% interest and extra charges.

Some insurance companies have started customizing their products to include mental health.
(8/9)

But the country still has a long way to go before such claims are accepted without dispute.

What are your thoughts on this? Tell us in the comments below!
(9/9)

#BimaPeBharosa #India #Mentalhealth #insurance