Insurance Company to pay Mediclaim of Rs 3+ lakhs to Weight Loss Surgery Patient
Insurance Regulatory and Development Authority of India (IRDAI) issued the new guidelines on 1st October 2019 for bariatric/ weight loss surgery and now it is included in health insurance coverage. It is a great relief for lakhs of obese patients in India.
Bariatric Surgery is a metabolic surgery and cannot be considered as cosmetic surgery. In 2017, the consumer dispute redressal forum in Vadodara accepted this fact and a patient named Pratima Parikh received the mediclaim of Rs. 3.24 lakh with 9% interest. This was one of the few initial cases that helped in bringing a change.
Mrs. Pratima Parikh weighing 124 kg was morbidly obese with BMI 58.54 and she underwent bariatric surgery. She had mediclaim policy with National Insurance Co. Ltd., but the company rejected her claim by citing the surgery falls under the category of cosmetic surgery and cannot be reimbursed.
Her husband filed the case in Vadodara and by quoting the facts it was proved that “Repudiation of a claim by the insurance company is the deficiency in service and unfair trade practice”. Court noted in its order that the World Health Organization has declared that morbid obesity is a disease and it is associated with the risk of many diseases that can be cured with bariatric surgery.
This was the major turning point for all the morbidly obese patients who could not afford the weight loss surgery prior to this decision. Now they can easily get rid of obesity and the associated co-morbidities like type 2 diabetes, hypertension, asthma, knee pain, sleep apnea, etc.
Now all the insurance companies in India will have to offer weightloss/ bariatric surgery cover to customers purchasing policies after 1st October 2019. Those who are existing policyholders, the cover will be included after 1st October 2020.
Now without worrying about the financial part, one can go for bariatric surgery. Contact a bariatric surgeon now and have a consultation to fight against obesity. Call – 6232012342
Editor’s Note: This post was originally published in July 2017 and has been updated for freshness, accuracy, and comprehensive.