INCOME TAX9 Sept 2026
Can health insurance claim be rejected for no hospitalisation? Karnataka HC ruling explained | Mint
The Karnataka High Court has ruled that health insurers cannot reject a claim only because the treatment didn't need hospitalisation. This helps policyholders, as many treatments like injections are now given without an overnight stay. The court said hospitalisation is just a method of giving treatment, not the deciding factor. Insurers must look at whether the treatment relates to a covered disease before refusing payment.
Key Statutory Highlights
- Karnataka High Court on 1 September 2026 said a health claim cannot be rejected only because treatment didn't require hospitalisation, especially for ongoing care of a covered disease.
- The ruling came in a case where National Insurance refused to pay ₹2,85,470 for Zoladex and Xgeva injections for a stage IV prostate cancer patient.
- The court observed that hospitalisation is only a means to administer treatment, not an end in itself, as medical advances now allow treatments without hospital admission.
Actionable Advice for Taxpayers / Founders:If your insurer rejects a claim only because you weren't hospitalised, review your policy terms and check whether the treatment relates to a disease already covered. You can challenge the rejection and, if needed, approach the consumer forum or court for relief.
Statutory Disclaimer: TaxQue Shorts are AI-assisted editorial briefs for compliance awareness. This brief has not passed every source check; confirm the original notification before acting. This does not constitute formal legal or CA counsel.
TaxQue News Desk
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