### Mumbai Consumer Court Orders Niva Bupa To Pay ₹66.5 Lakh For Overseas Cancer Treatment
The District Consumer Disputes Redressal Commission in Mumbai has directed Niva Bupa Health Insurance Company to compensate a policyholder after unfairly rejecting an overseas medical insurance claim. The commission ordered the company to pay the principal amount of ₹66.5 lakh, which was the insured sum for cancer treatment abroad, along with additional compensation for mental distress and litigation costs.
### Details of the Case
According to the commission, the complainant had obtained a Niva Bupa health policy covering international medical treatment. After being diagnosed with cancer, the person received treatment overseas and filed a reimbursement claim. The insurance provider rejected the claim, citing procedural and documentation issues, which the commission later found to be unjustified.
The bench held that the company’s actions amounted to a “deficiency in service” under the Consumer Protection Act. It emphasized that health insurance companies must process genuine claims with transparency and fairness, particularly in serious medical cases.
### Commission’s Order
The District Commission directed Niva Bupa to:
- Pay ₹66,50,000 to the complainant as the insured amount.
- Provide ₹1 lakh as compensation for mental agony and harassment.
- Cover ₹25,000 toward legal expenses.
- Comply with the order within 60 days.
The commission also warned that failure to comply within the stipulated time would attract additional interest on the total payable amount.
### Broader Implications
This ruling highlights the obligation of insurers to act in good faith and avoid arbitrary rejection of valid claims. It reinforces consumer rights against unfair practices by insurance companies, especially in cases involving critical health conditions like cancer.
> “Health insurance should be a shield for patients in distress, not another source of suffering,” noted the commission in its observations.
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**Author’s summary:**
Mumbai’s consumer court ordered Niva Bupa to pay ₹66.5 lakh plus damages for wrongfully rejecting a cancer patient’s overseas treatment claim, emphasizing fairness and insurer accountability.
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Free Press Journal — 2025-11-29