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health insurance denial of claim


18-Jun-2026 (In Recovery Law)
wife admitted 2019 for surgery. She was in ICU with Ventilator support for 14 days. Ventilator fees for Rs. 2 lakhs denied as not necessary. Without ventilator support she would not have survived.Is it not a wrong denial.? Can I file a case against this.?
Answers (1)

Answer #1
864 votes
Based on the facts stated, if the treating doctors advised ventilator support as medically necessary and the health insurance company rejected the ventilator charges without valid reasons under the policy terms, such repudiation may be challenged. Please verify the insurance policy, repudiation letter, discharge summary, ICU records, ventilator treatment records, doctor's opinion, and medical bills. If the insurer has wrongly denied a genuine health insurance claim, it may amount to deficiency in service and unfair trade practice. You may file a case before the Consumer Commission seeking reimbursement, compensation, and other appropriate relief. A detailed review of the documents is necessary before giving a final legal opinion.
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