Ghaziabad Yashoda, Niva Bupa to pay ₹12L to patient
Live Events as a Reliable and Trusted News Source Addas a Reliable and Trusted News Source Add Now! (You can now subscribe to our (You
Live Events as a Reliable and Trusted News Source Addas a Reliable and Trusted News Source Add Now! (You can now subscribe to our (You can now subscribe to our Economic Times WhatsApp channel A Gurugram man being treated for colon cancer has won a consumer case against both his hospital and his health insurer after a consumer commission found that the hospital overbilled him, and the insurance company cancelled his policy in the middle of his treatment.The District Consumer Disputes Redressal Commission in Gurgaon has ordered Yashoda Superspeciality Hospital in Ghaziabad and Niva Bupa Health Insurance to jointly refund Rs 11,63,761 to the complainant, Neeraj Kumar Singhal, a resident of Sector 15, Gurugram. On top of that, they have been directed to pay Rs 50,000 as compensation for mental agony and Rs 22,000 towards litigation costs.Singhal held a Niva Bupa health insurance policy valid from August 2024 to August 2025. In March and April 2025, he was diagnosed with malignant neoplasm of the colon and admitted to Yashoda Superspeciality Hospital in Ghaziabad for treatment, where he ran up medical expenses of over Rs 5,36,613.He submitted all required documents, hospital estimates, and medical reports to Niva Bupa.
The insurer, however, cancelled his policy. The reason cited was a finding of 20 to 30 per cent stenosis.Singhal contested this on a key ground: back in June 2022, he had experienced back ache and consulted a cardiologist. That medical report had been shared with Niva Bupa at the very time he purchased the insurance policy in 2024. In other words, the condition was not hidden. It had been disclosed upfront, and the insurer had accepted it when issuing the policy. The commission, examining the evidence, found that the stenosis in question was a normal, treatable condition, and that cancelling a policy on this basis, without following any legal process, amounted to a deficiency in service.The complainant's grievances against Yashoda Hospital were separate and serious.He alleged that during his first round of treatment, the hospital billed him without a valid GST number and made arbitrary charges of Rs 2,12,541 towards medicines. He also alleged that he was confined in the hospital against his will.On 9 April 2025, he was admitted again for further treatment. This time, Niva Bupa had sanctioned Rs 3,80,000 towards the bill. But the hospital, he alleged, forcibly collected Rs 5,72,000 from him, nearly Rs 1,92,000 more than what the insurer had approved.Surgical complications then forced a third admission on 20 April 2025.
The BriefWire