The South Mumbai district consumer dispute redressal forum pulled up New India Assurance company for unfair trade practices and directed it to pay a consumer Rs 1,23,530 along with 6% interest on the amount from 2013. It also directed the company to pay the consumer an additional Rs 10,000 and Rs 5,000 toward mental agony and litigation cost, respectively.
According to the order, complainant Mayadevi Todi, a resident of Thane, bought a Mediclaim policy from the insurance firm with a medical cover of Rs 1.5 lakh. The policy was active between July 9, 2012 and July 8, 2013.
As per the complain, Todi had pain in her knees and could not do routine work, and was advised medication by her family doctor. However, the medication failed to relieve her pain. She then heard about a non-evasive treatment for Osteoarthritis called Sequential Programmed Magnetic Field (SPMF), which was originally known as Quantum Magnetic Resonance (QMR therapy). A Bangalore-based company, Cartigine Health Care Pvt Ltd, was offering it, and it had a branch in Andheri (SBF Healthcare Pvt. Ltd).
Todi was told that for the treatment she wouldn't have to get admitted and would only need to go to the centre on prescribed days.
"On the first day of treatment, the complainant had to stay at the centre for eight hours to undergo several tests like blood investigation, rehab exercise, pain management, etc. She was thereafter advised to take vitamins and follow certain diet restrictions for the next three months," the complaint says. After taking treatment, Todi produced the bills at the insurance firm for reimbursement. However, it told her she could not be paid because, as per one of the clauses in the contract, the medical treatment Todi had availed at SBF Healthcare Pvt Ltd for severe Osteoarthritis (of both knees) was an experimental and unproven treatment not recognized by the Indian Medical Council.
Todi then approached the consumer forum and filed a complaint in 2013. The forum found the company at fault and penalised it.
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