Ahmedabad: 'High BP common, can't be termed aspre-existing illness'

AHMEDABAD: Holding that hypertension cannot be termed as a pre-existing disease, a consumer court has ordered an insurance company to pay mediclaim to a policyholder for the treatment of mucormycosis.

The treatment cost of the fungal infection contracted after Covid-19 infection during the deadly second wave was denied on the ground that the patient was suffering from hypertension and had concealed this information while obtaining health cover.

The Gandhinagar District Consumer Dispute Redressal Commission observed that hypertension has become so common nowadays that it cannot be considered a disease. “Since hypertension can be kept under control with help of pills, it cannot be termed as a pre-existing disease,” the court observed.

In this case, Gandhinagar resident Amrutbhai Patel, a retired employee, contracted Covid-19 in April 2021 and was treated for five days in hospital. After recovering from Covid, Patel continued to suffer health issues. After numerous tests, he was diagnosed with mucormycosis a month later.

Patel underwent a surgery in a private hospital in May 2021. He paid Rs 7.52 lakh for treatment of black fungus. He had a health insurance from Reliance General Insurance Co Ltd. The insurer did not extend the cashless facility to him. When he claimed a refund, the insurer rejected his claim.

Patel filed a complaint with the consumer commission, where the insurance company defended its repudiation on the ground that Patel’s medical history-sheet reflected that he was suffering from hypertension for one decade, but he had not revealed about his ailment while obtaining the health policy four years ago. The insurer company termed it a breach of non-disclosure clause and said that his policy was liable to be cancelled.

After hearing the case, the commission said, “At present, hypertension is becoming a very common ailment in a large number of people. In fact, this has not even remained a disease. A person having hypertension can keep it under control by taking pills and live a normal life. Since hypertension can be kept under control with help of medication, it cannot be termed as a pre-existing disease."

"What is important in this case is that diseases like Covid-19 and mucormycosis do not have anything to do with hypertension. There is no connection between them.” With this observation, the commission ordered the insurer to pay Rs 7.52 lakh to Patel with 7% interest.

The insurer has also been asked to pay Rs 10,000 extra as compensation for harassment and legal expenditure.