The Bombay High Court has held that insurance companies cannot deny health insurance claims solely because they were filed after the deadline specified in the policy.
In its order, a division bench of Justices Bharati Dangre and Manjusha Deshpande directed the insurer to reimburse the claim amount within eight weeks, along with 6% annual interest from the date the payment became due.
The case was filed by CP Ravindranath Menon against United India Insurance Company over the rejection of a ₹1.13 lakh medical reimbursement claim under a group health policy issued through Export-Import Bank of India.
The insurer had rejected the claim on the grounds that it was submitted beyond the policy’s 90-day filing period. However, the court ruled that such restrictive clauses cannot override a policyholder’s legitimate entitlement to benefits and declared the condition void and unenforceable.
Legal experts say the ruling could have wider implications for both group and individual health insurance policies, as it limits insurers from rejecting valid claims on procedural grounds.
