The Indian Express ·
No hospital stay? Karnataka High Court backs Rs 2.8 lakh cancer treatment insurance claim
Giving injections without hospitalisation every three months after the chemotherapy cycle did not disconnect them from the underlying disease or its treatment, the court stated.
Observing that “hospitalisation is not an end in itself” but only a mode of administering medical treatment, the Karnataka High Court recently held that an insurance company cannot deny coverage to a person just because his cancer treatment was administered without hospitalisation.
Justice Suraj Govindaraj observed in the September 1 order that giving injections at intervals of three months and after the chemotherapy cycles did not disconnect them from the underlying disease or make them unrelated to the insured condition. The court said the patient cannot be expected to get an unnecessary hospital admission just to bring the treatment within the insurer’s preferred interpretation of the policy, and upheld the reimbursement of Rs 2.85 lakh.
“Hospitalisation is not an end in itself; it is a mode in which medical treatment may be administered. Where advances in medical science enable a treatment which would otherwise have required a longer hospital stay to be administered safely and effectively without hospitalisation, the absence of hospitalisation cannot, by itself, be treated as determinative of whether the treatment is connected with the insured disease,” the order stated.