Rishikesh woman who donated kidney to husband wins 13-year mediclaim battle
Dehradun: A Rishikesh woman who donated a kidney to her husband during a 2012 transplant surgery won a 13-year legal battle after the insurer denied her hospitalisation claim, saying she was not a patient.
The Uttarakhand State Consumer Commission on Friday ordered National Insurance Company Limited (NICL) to pay the dues with interest and compensation to Renu Bansal.
Renu had filed a complaint against NICL for denying expenses incurred during her hospital stay as an organ donor. Her husband, Jagannath Bansal, had taken a mediclaim policy covering himself and family, which he had renewed continuously for 13 years.
In Feb 2012, he underwent a kidney transplant surgery, with Renu as the donor.
While NICL partly reimbursed Jagannath's costs, it refused to cover Renu's hospitalisation, arguing that she was not the patient. In 2014, the district consumer commission ruled in her favour, but NICL challenged the decision before the state commission. Jagannath died during the prolonged legal process, but Renu continued to fight the case.
The state commission upheld her claim, ruling that the policy covered donor expenses up to 50% of the sum insured. "As per the clause, donor Renu Bansal, who was insured for an amount of Rs 65,000 on the date of kidney transplantation and incurred an amount of Rs 66,667 towards costs of transplantation, is entitled to get a maximum of 50% of the sum insured, which is Rs 32,500," the commission said.
NICL was directed to pay Rs 32,500 along with 7% annual interest from the date of the complaint in 2012.
The commission also awarded Rs 25,000 to Renu as compensation for mental agony and litigation expenses.
Organ donor coverage in India varies widely between insurers. While some mediclaim policies include hospitalisation expenses for organ donors, many others exclude them or cap them under sub-limits. A 2022 industry review found several insurers refusing new policies or renewing existing ones for people who had previously donated an organ. Policy clauses are not standardised, which often results in disputes.
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