#consumer insurance

Insurers may not rely on informal security measures not written into the policy to deny coverage, and a corporate entity is recognised as a consumer under the Consumer Protection Act. The commission awarded the claimant Rs 44.53 lakh with interest and costs. This ruling mandates that policy exclusions be expressly documented and extends consumer protections to corporate borrowers.

Insurers cannot deny claims based solely on elevated HbA1c levels without corroborating medical records or clinical diagnosis. The NCDRC has ruled that mere biochemical data, without contextual medical history or physician evaluation, fails to meet the burden of proof for excluding pre-existing conditions - a critical win for policyholders facing arbitrary claim rejections.