SHANTI UPADHYAY vs SR. DIVISIONAL MANAGER OF NEW INDIA ASSURANCE, COMPANY LTD. & ANR.

Judgment text excerpt

$~81 * IN THE HIGH COURT OF DELHI AT NEW DELHI % Date of Decision: 25th February, 2025 + W.P.(C) 2377/2025 & CM APPL. 11255-11256/2025 SHANTI UPADHYAY .....Petitioner Through: Mr. Krishna Chanda Dubey, Advocate. versus SR. DIVISIONAL MANAGER OF NEW INDIA ASSURANCE, COMPANY LTD. & ANR. .....Respondents Through: Mr. J.P.N. Shahi, Advocate for New India Insurance Co. CORAM: HON'BLE MR. JUSTICE MANOJ JAIN J U D G M E N T (oral) 1. Petitioner is aggrieved by order dated 06.12.2023 whereby despite her having a medical insurance, her claim has been rejected. 2. According to learned counsel for the petitioner, New India Assurance Company Limited has rejected the claim on the ground that the patient remained admitted for less than 24 hours and, moreover, the disease in question did not come under Day-Care Procedures. 3. Learned counsel for the petitioner submits that respondents have taken a very strict and rigid interpretation of the word ‘hospitalization’ and claim has been rejected while observing that ‘hospitalization‟ means admission in a hospital for a minimum period of 24 consecutive hours of in-patient care. 4. Learned counsel for petitioner submits that even as per the Signature Not Verified Digitally Signed W.P.(C) 2377/2025 1 By:SONIA THAPLIYAL Signing Date:27.02.2025 11:45:52 policy in question, there is a Note attached with Clause 11 which provides that for treatment like dialysis, chemotherapy, radiotherapy etc., if the insured person is discharged on the same day, the treatment shall be considered to be taken under Hospitalization Benefit Section. 5. Petitioner submits that she had taken treatment for Osteoarthritis of knee joints and petitioner had even undergone surgery though she was discharged, same day. 6. Feeling aggrieved by the aforesaid rejection of her c