Delhi resident Gyan Chand and his wife Mahadevi bought a flat worth ₹50 lakh in Noida in 2017. It was an under-construction flat for which he took a loan of ₹24 lakh. He also bought a group personal accident policy to secure the loan. Unfortunately, he died in October 2021 after a prolonged hospitalisation for a fall. His daughter Renu Ambesh (29) approached the insurer with the death claim, but it was rejected.
«Half of my father's body was already paralysed [when we bought the policy]. We had disclosed this, his hypertension, and other diseases when buying the personal accident policy. The insurer rejected the claim, saying his death was due to a seizure and not an accident. This wasn’t written in any of the medical documents,» Ambesh said.
Chand had suffered a paralysis attack in June 2021, months before he died, and got better in the following weeks. «He had started going to work as well. On 9 August 2021, he slipped on the stairs. We took him to a CGHS (Central Government Health Scheme)-empanelled hospital in Delhi. There was a lot of internal bleeding and it became a case of brain haemorrhage. The surgery began the same day and lasted 24 hours,» Ambesh said.
Hospital expenses were not an issue as he was covered under CGHS. But, being a CGHS patient came with its own set of challenges. The hospital discharged him forcefully, said Ambesh. «They told us they couldn’t keep a CGHS-empanelled patient for a long time. They put pressure on us for a forced release. We had to arrange for everything from an oxygen cylinder to a concentrator and a suction machine at home. Within an hour of reaching home, he felt uneasy so we took him to a hospital nearby,» she added.
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