Only doctors can decide patient's line of treatment and not
Only a doctor and not the insurance company can decide the line of the treatment given to a patient. This terse observation was made by a consumer court in Vadodara, which ordered the insurance firm and third-party administrator (TPA) to pay the insured amount to a citizen.

The patient was suffering from cervical spondylosis for which she underwent treatment for three days at the hospital. A month later the TPA Paramount Health Services and Insurance rejected her claim on the grounds that ‘no active line of treatment was given during hospitalization’.

‘Treating doctor’s opinion more truthful than TPA’s’

The lawyer Montu Pandya said, "During hospitalization, the doctor prescribed x-ray, laboratory tests, several medicines, injections and consulting a physician. But the insurance company claimed that such treatment was not needed for treating cervical spondylosis and therefore they rejected the claim giving reason that no active treatment was given."

The patient's husband then approached the Vadodara District Consumer Disputes Redressal Forum in August 2018 against insurer National Insurance Company and the TPA. He submitted the discharge report along with doctor’s certificate that mentioned. The patient's health condition and the treatment offered to her.

However, the court ruled that "No insurance company can decide the line of the treatment to be given to a patient, only doctors can decide about the treatment."

Dr. T●●●i and 67 others like this15 shares
Dr. P●●●●●●●a B●●●●●●●●●●a
Dr. P●●●●●●●a B●●●●●●●●●●a Other
Right...... and that' s exactly how it' s supposed to be. Doosre k job duties pe kabhi hum jate hai problems khadi karne.
Apr 30, 2019Like
Dr. DR H●●. C●●●●●●●●●●I H●●●●●I
Dr. DR H●●. C●●●●●●●●●●I H●●●●●I Internal Medicine
Very well said Insurance cos don' t have to question about the way of tt. This should be highlighted everywhere to feel free to treat the case
May 7, 2019Like3
Dr. T●●●●●●g N●●●●●l W●●●●i
Dr. T●●●●●●g N●●●●●l W●●●●i General Medicine
This is the general excuse of Insurance companies - ' No active management done ' ..... and the Mediclaim is rejected and We have to bear the bashing and accusations from patient party....Assholes !!
May 10, 2019Like