Insurer rejects mediclaim citing 'mismatch' over Google Timeline; consumer forum gives man relief
The man from Silvassa had to knock on the door of the Consumer Dispute Redressal Forum in Valsad district, which ruled in his favour and directed the company to settle the claim with interest.
In its order of July 14, made available recently, the president of the consumer forum, B G Dave, directed the firm to pay Rs 48,251 (mediclaim amount) with 8 per cent interest within 30 days of the order.
Vallabh Matka, who had a mediclaim policy from
Go Digit General Insurance
Limited, was admitted to a private hospital in Silvassa in September 2024 for four days after he contracted viral pneumonia.
After his discharge, Matka submitted medical bills to the insurance company for reimbursement. However, it rejected the claim, saying there were discrepancies over his Google Timeline.
Google Timeline, earlier called Location History, creates a map of the places a person has been and the routes the individual has taken on each of their devices.
Left with no option, Matka approached the consumer forum, a quasi-judicial body with the power to make decisions and resolve certain disputes like a court.
After being issued a notice, the company told the forum that there were many inconsistencies concerning Matka's claim.
"Upon internal verification of the claim, we noted that there are multiple discrepancies in submitted bills, indoor case papers and we have also noted discrepancies from insured statement to his verified Google Timeline," the company told the forum.
As per the customer's statement, his phone was with him during hospitalisation, but as per Google Timeline, "the hospital location was not found in the patient's Google Map", it said.
The forum, however, relied on the hospital's statement and other records.
"In the report by the insurance company, it has said that the patient was admitted to the hospital and received treatment but it seems that they wanted to reject the claim and are giving false reason that the Google map timeline is not matching," the forum said, ordering the firm to settle the claim and pay 8 per cent interest. PTI
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
&w=3840&q=100)
Business Standard
27 minutes ago
- Business Standard
Man denied mediclaim over Google Maps mismatch: Here's all you need to know
In a rare but telling case, a Gujarat resident's health insurance claim was rejected because his Google Timeline didn't match the hospital location. According to a PTI report, Vallabh Matka from Silvassa was admitted to a hospital in September 2024 for viral pneumonia and later denied reimbursement by Go Digit General Insurance, which flagged discrepancies between his statement and his phone's location data. The Valsad district consumer forum ruled in Matka's favour this month, noting that the insurer had no justifiable grounds and must settle Rs 48,251 with 8 per cent interest. Can insurers legally reject claims using Google data? 'Insurers can reject a claim based on Google Timeline, but only under strict conditions,' said Hari Radhakrishnan, expert at the Insurance Brokers Association of India (IBAI). 'The data must be lawfully obtained with informed consent under India's digital data protection laws and should decisively support the insurer's claim. But mobile phones can be used by others, so the data often needs corroboration,' he said. Anita Teli, chief compliance officer at Probus Insurance, clarified that digital data cannot be treated as standalone proof. 'Insurers must rely on medical records, bills, and discharge summaries. Digital tools may support a fraud investigation but aren't legally admissible as sole evidence,' Teli said. How policyholders can protect themselves Teli advised policyholders to keep full documentation, including prescriptions, hospital admission records, and discharge papers. 'Make sure you notify your insurer upon hospitalisation and avoid any mismatches in submitted forms,' she said. Radhakrishnan added that consumers should understand data-sharing implications before granting access to personal digital information. 'If you suspect misuse, raise a grievance with the insurer. If unresolved, escalate to the ombudsman,' he said. Is this part of a broader trend? Both experts agree that insurers are increasingly using digital tools to detect fraud, but not for blanket claim denials. 'There have been cases where Google data was used to disprove someone's presence at an accident site,' Radhakrishnan noted. But Teli clarified these are exceptions, not the norm. What to do if your claim is wrongly denied Consumers have multiple channels for redressal. 'Start with the insurer's grievance redressal team,' said Teli. 'If the issue persists, register on the Irdai's Grievance Management System or approach the Insurance Ombudsman.' While consumer forums offer recourse, Radhakrishnan cautioned that they are often burdened with cases, making resolution slow.
NDTV
an hour ago
- NDTV
Infant Loses 5 Fingers, Chennai Hospital Ordered To Pay Compensation
Chennai: The Chennai North District Consumer Disputes Redressal Commission has directed a hospital and a doctor, here, to provide compensation of Rs 23.65 lakh spent on treatment, besides Rs 10 lakh for pain and suffering caused after a 24-week-old boy lost five fingers allegedly due to gangrene. The Commission held the city hospital and the gynaecologist liable for negligence and directed them to pay the compensation and also Rs 10,000 towards the cost of litigation, recently. It said the hospital and the doctor 'failed to justify the emergency nature of the procedure or explain why consent was bypassed.' The boy's premature birth was reportedly caused by a cervical pessary procedure (non-invasive insertion of a silicone ring in the vagina to support the cervix) without obtaining due consent. The procedure led to the boy developing gangrene, and the Commission held that the premature insertion done without testing or emergency need led to complications, including preterm delivery at 24 weeks. The baby's mother was undergoing fertility treatment, and she was 22 weeks pregnant when the device was inserted. It was said that during post-delivery and transfer to the NICU, the baby developed early signs of gangrene. As a result, all five fingers of his right hand were amputated.
Mint
2 hours ago
- Mint
SEA urges CCPA, FSSAI to take action against misleading social media claims on refined oils
New Delhi, Jul 28 (PTI) The Solvent Extractors' Association (SEA) has urged the Central Consumer Protection Authority and food safety regulator FSSAI to take action against misleading content on refined edible oils circulating on social media platforms. In a letter written to CCPA and FSSAI, SEA said a viral video posted by the Instagram account @satvicmovement has been making "alarming and factually incorrect claims" about refined edible oils, labelling them as "chemical-laden" and "toxic". "The video has gained widespread traction, creating confusion among consumers and casting unfounded doubts on the safety of refined edible oils, which form the majority of India's edible oil consumption," SEA said in a statement. The association warned that such misinformation threatens not only consumer confidence but also the livelihoods of farmers and the credibility of India's food safety ecosystem. It stressed the need to provide accurate, science-backed information to the public. To counter the viral video, the industry body has released a comprehensive explanatory note to clarify the scientific and regulatory realities of edible oil refining with evidence-based facts. SEA pointed out that about 85 per cent of India's edible oil consumption comes from refined oils such as palm, soybean, sunflower, rice bran, and cottonseed. These oils are processed under strict Food Safety and Standards Authority of India (FSSAI) norms and meet globally accepted Codex Alimentarius standards. The association defended the use of food-grade hexane, saying it is safe and regulated. Hexane is a food-grade solvent commonly used in oil extraction and is removed during processing, with final products meeting the FSSAI-prescribed limit of 5 ppm, which is within safe toxicological thresholds recognised globally. SEA also emphasised that refining is a scientifically necessary and approved process, essential to remove natural impurities and ensure safety, stability, and shelf life of edible oils. It said FSSAI regulations are strictly complied with for processes such as deodorisation. "Alarmist messages like those in the viral video pose broader risks to the agri-economy, potentially discouraging consumers, affecting oilseed farming, and damaging trust in a heavily regulated industry," the association said.
