Last Update: January 20, 2023, 20:47 IST
The Permanent Lok Adalat had rejected the contention raised by the insurance company. (Representational photo)
An insurance company – Star Health and Allied Insurance Company Limited – had filed a writ petition challenging the order of the Permanent Lok Adalat allowing the insurance claim of a person who had taken a Corona Rakshak insurance policy.
Dismissing a writ petition filed by an insurance company, the Kerala High Court recently held that a Covid First Line Treatment Center (CFLTC) can be called a ‘hospital’ for the purpose of insurance claims.
A bench of Justice VG Arun said, “CFLTCs are primary level health care centers established to take care of mild cases and refer serious cases to Covid hospitals, to avoid overcrowding in Covid hospitals and optimize resources. wastage can be avoided. Therefore, it can be assumed without any hesitation that CFLTCs have been designated as hospitals for treatment of COVID-19.”
The insurance company – Star Health and Allied Insurance Company Limited – had filed a writ petition setting aside the order of the Permanent Lok Adalat allowing the insurance claim of a person who had taken a Corona Rakshak insurance policy from the company.
The Permanent Lok Adalat had rejected the contention raised by the insurance company that in order to avail the benefits under the said policy, hospitalization for a minimum continuous period of 72 hours was necessary for positive diagnosis of Covid and the existing policyholder Was only admitted to the hospital. CFLT Centre, therefore, could not claim the sum insured.
The main contention of the insurance company was that the CFLTC from which the policyholder was sent from the Government Medical College Hospital was an institutional quarantine facility and not a hospital.
The Single Judge Bench of the High Court referred to the relevant policy and observed that ‘hospital’ means any institution established for inpatient care and day care treatment of illness/injuries and which is defined as a hospital with local has been registered. Authority under the Clinical Establishments (Registration and Regulation) Act, 2010 or under the Acts specified under the Schedule to section 56(1) of the said Act, or comply with all the minimum norms given.
The Court further noted that it was also clarified in the policy that for the purpose of the policy, any other set-up designated by the government as a hospital for the treatment of COVID-19 would also be deemed to be a hospital.
Further, while deciding whether CFLTCs have been designated by the government for COVID-19 treatment, the court referred to the COVID-19 advisory for patient admission to CFLTCs issued by the government in 2020.
“In it, it is specifically stated that the center identified as a COVID health care center should treat all mild and moderate symptomatic persons under surveillance and be used to treat positive cases as and when required, The court highlighted.
In view of the same, the court held that the contention raised by the petitioner company was not sustainable.
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