Insurance Company Rebuked for Denying Parkinson's Patient's Physiotherapy Claims

The Navsari District Consumers Dispute Redressal Commission (CDRC) has ruled against United India Insurance Company Ltd for deeming a Parkinson’s disease patient’s physiotherapy as ‘outpatient’ treatment and rejecting the bills. Dinyar Gazdar, a 66-year-old resident of Navsari, underwent physiotherapy sessions from February 29 to December 17, 2020, following a doctor’s prescription for his Parkinson’s disease.

Gazdar, covered by a Rs 3 lakh group insurance policy, faced rejection of his Rs. 47,500 physiotherapy bills. The insurance company argued that the treatment was outpatient-based and claimed that Gazdar failed to provide requested documents to the third-party administrator (TPA).

The CDRC, however, disagreed with the insurance company’s stance, emphasizing that the physiotherapy was prescribed by a doctor and should not be classified as ‘outpatient’ treatment. The commission ordered United India Insurance Company Ltd to reimburse the full amount to Gazdar.

Gazdar’s medical journey began when he was diagnosed with Parkinson’s disease at Mumbai’s Lilavati Hospital in January 2020. Despite being admitted as an indoor patient for two days, the insurance company rejected the physiotherapy claims, leading Gazdar to seek justice from the CDRC, which ultimately ruled in his favor on January 11, 2023.