Quasi Judicial Patients, & Victims of Insurance Companies Institutional Exploitation
How are insurance companies institutionally exploiting quasi-judicial patients in unanimity?
I’m demanding 5000 Crore INR from HDFC ERGO as a relief on behalf of the District Consumer Forum (quasi-judicial court) because every health insurance policyholder is at risk of becoming the next victim of institutional exploitation by insurance companies in unanimity with the quasi-judicial consumer forums in India.
The capping on maximum relief amount under the district consumer court’s jurisdiction has been exploited by Insurance companies and other companies (healthcare, fintech). Everyone knows that visiting the court for a thrifty amount dispute is a hassle because of lengthy procedures, followed by submitting a heap of hard copies, followed by multiple times appearances. The huge number of thrifty amount disputes w.r.t. the few complaints been made in consumer court w.r.t. the fewer complainants actually following through till the end to receive relief from the court decreases considerably in each step.
In my opinion, this has been statistically calculated by the Insurance companies and other companies (healthcare, fintech). The capping on the maximum relief amount that could be disbursed by the district consumer court is working like protection by the Government of India for the Insurance companies by applied statistics. It means the Insurance companies are booking huge profits by deliberately committing thrifty amount disputes in a very large volume only to reimburse the district consumer court capped relief amount to the very few complainants that could actually make it to the end. The 20–30 times relief disbursed by consumer forums on a thrifty amount like 500, 2000, and 10k lawsuit, to the fraction of policyholders (quasi-judicial patients) that could make it to the end of litigation and win the lawsuit, in most cases equates to less than a daycare procedure or 24-hour hospitalization that isn’t a matter of concern for Healthcare Insurance companies. Unlike a disease or accident that is contingent, the thrifty amount’s financial exploitation on policyholders is intentionally committed by insurance companies. This is the reason I often witness thrifty complaints but the relief amount is not checking the wrongdoing of the Insurance companies once and for all. Such institutional exploitation by insurance companies in unanimity with the quasi-judicial consumer forums puts every policyholder at risk. Thus I’ll request the Government of India to bring in the provision of a class action lawsuit and amend the capping on maximum relief that could be disbursed by the District Consumer Court and demand relief for 5000 Crore INR instead of 50,000 INR for consumer court reference number A22080005770 case no CC/354/2022, in the hope to send a positive message loud and clear to the Insurance, Fintech, & Healthcare Sector.
A detailed copy of the litigation for public review
HDFC ERGO Health Insurance full body health checkup Claim Number RR-FC21–12734614. HDFC ERGO Optima Restore Health Insurance Policy number 2805203553540501. Insurance Ombudsman Complaint Number — KOL-H-018–2122–0878 and Insurance Ombudsman Award Number — IO/KOL/A/HI/0036/2022–2023. IRDAI complain no 08–22–008408. GRO HDFC ERGO Ref 57153289. District Consumer Dispute Redressal Forum, Barasat, North 24 Parganas, India, eDaakhil reference number A22080005770 and case number CC/354/2022.
Tweet Thread, Timeline of the Events. (Link)
First in the series is, How effective is complaining to the Insurance Ombudsman and the Insurance Regulatory and Development Authority of India (IRDAI)? (Link)
Next in the series is, Collection of Key Email Conversations with HDFC ERGO regarding Yearly Health Checkup Claim Repudiation. (Link)
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Last edited on 12 July 2023.