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ARTICLE · 14 NOVEMBER 2025

Applying Sub-Limit To Wrong Procedure Amounts To Deficiency In Service, Rules Ernakulam Consumer Commission

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In a significant ruling reinforcing the rights of insured consumers, the District Consumer Disputes Redressal Commission, Ernakulam, has held Future Generali India...

IndiaConsumer Protection
Ritika Dedhia
Ritika Dedhia

Introduction

In a significant ruling reinforcing the rights of insured consumers, the District Consumer Disputes Redressal Commission, Ernakulam, has held Future Generali India Insurance Company Ltd. and its affiliate Future Generali Health1 guilty of deficiency in service and unfair trade practice for wrongfully curtailing a legitimate medical insurance claim. The Commission found that the insurer had misapplied a policy sub-limit intended for urinary stone removal to a completely different surgical procedure, thereby causing undue financial and emotional distress to the complainant.

Background of the Case

Complainant Lype P. Joseph, insured under a group health policy of Future Generali India Insurance Company Ltd. (Policy No. FGS-39-24-7006584-00-000), had coverage of ₹5,00,000 for the policy period 05.04.2024 – 04.04.2025. Upon hospitalization for bulbar urethral stricture, he underwent Visual Internal Urethrotomy (VIU) at Apollo Adlux Hospital, Ernakulam,

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