Insured under health scheme cannot be denied reimbursement: Madras HC
Chennai: The Madras High Court has ruled that an insured covered under health insurance scheme cannot be denied reimbursement of treatment cost merely because the ailment is not included in the list of insurance schemes. Once a person is validly covered by the health insurance scheme and when he has taken treatment in an accredited hospital,he cannot be denied the reimbursement of cost of treatment, Justice T Raja said. The court ruling came on a petition by G Simon Cristudoss who was insured under the state government employees health fund scheme since 1998. Cristudoss underwent an eye operation,after which he submitted bills for reimbursement. It was rejected on grounds that the ailment as diagnosed was not covered under the list of diseases under the scheme. Faulting the rejection order,the judge said authorities should not have rejected the claim when the indured is a regular subscriber and the hospital an accredited one for specialized advanced surgeries. Justice Raja then directed the authorities to pay the entire claim amount with 8 per cent interest to the petitioner.
Pension Fund Regulatory Bill gets Presidents assent
New Delhi: President Pranab Mukherjee gave his assent to the Pension Bill,that provides for investment of funds in equity market and opens the sector to up to 26 per cent FDI. The long-pending Pension Fund Regulatory and Development Authority (PFRDA) Bill was passed by Parliament on September 6. The legislation provides subscribers a wide choice to invest their funds including for assured returns by opting for government bonds as well as in other funds depending on their
capacity to take risk,a provision that came from opponents of the legislation. It pegs the FDI in pension sector at 26 per cent or such percentage as may be approved for the insurance sector,whichever is higher. Tha Act makes the Pension Fund Regulatory and Development Authority a statutory authority. Prior to the passage of the legislation the PFRDA was an interim regulator.
Life insurance industry estimated to grow by 15% in next five years
Mumbai: The life insurance sector is estimated to grow by up to 15 per cent annually over the next five years,mainly due to multiple regulatory and industry changes brought in over the past few years and due to favourable demographics of the country,an industry body today said. The worst is over for the life insurance industry that has not seen very positive growth figures in the past few years. With favourable demographics,new products launches on the anvil,industry expanding their operations and infusing efficiencies,the (insurance industry will see significant growth in India, Life Insurance Council Secretary General V Manickam said. He further said that favourable demography,which is the insurable population,is expected to grow to 75 crore and life expectancy to 74 years by FY20,which would help achieve spurt in preference for life insurance. The life insurance industry is expected to record a compounded annual growth rate of 12-15 per cent over the next five years and the penetration measured as ratio of insurance premium to GDP is likely to grow to 5 per cent by 2020 from current 3.2 per cent, he said. PTI