Covid Gone, Claims Remain Unsettled: Over 2,500 Insurance Disputes Still Pending In Gujarat

It’s been more than five years since the peak of the COVID-19 pandemic, but for thousands of patients in Gujarat, the battle isn’t over. An estimated 2,500 cases related to pending or denied COVID-19 treatment claims are still stuck in various consumer forums across Gujarat. Many patients who bought health insurance policies specifically to cover COVID-related expenses are still waiting for their rightful reimbursements.

When the virus surged in 2020 and 2021, hospitals across the state overflowed with patients. During this time, insurance companies launched COVID-specific health policies, backed by IRDAI guidelines, promising to ease the financial burden of treatment. But when people filed claims, even with all the required documents, they often faced rejections, unreasonable deductions, or delays.

Frustrated policyholders turned to the legal system for relief. From district consumer forums to state and even national commissions, thousands of cases have been filed  and many are still awaiting judgment.

One such case from Ahmedabad is that of Sunilkumar Sukhwani who had a ₹3 lakh policy with Star Health Insurance. After being hospitalized with COVID-19 in 2021, he submitted a claim for ₹1.4 lakh. The company denied it. He took the matter to the Ahmedabad Consumer Forum. Another such case is that of Kaushal Trivedi, from Sargasan, who was treated at home during his COVID illness. He filed a claim of ₹74,613 with Oriental Insurance but was paid just ₹20,000. After a legal battle, the Gandhinagar Consumer Disputes Redressal Commission ruled in his favor, ordering the company to pay the remaining ₹49,152 along with 15% annual interest from January 2021.

Efforts to get an official count of COVID-related disputes in the courts have hit a dead end, as most cases aren’t tagged under any special category. However, legal aid groups and consumer rights organizations estimate the number in Gujarat alone exceeds 2,500.