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Bariatric surgery is not cosmetic surgery, but a life saving procedure, the Consumer Disputes Redressal Forum, Ahmedabad has said, while holding MedSave Health Care and United India Insurance Company Ltd guilty of deficiency in service and unfair trade practice.The Forum has asked the respondent firms to pay Rs 2,17,500 with 7 per cent interest to one Sudhir Sharma, along with Rs 3,000 for mental agony and Rs 1,500 towards cost. Sharma had complained of mental agony and harassment for deficiency in service.Sharma held a Mediclaim policy of United India for himself, his wife Deepika, and their children, in 2005.Deepika was hospitalised from February 16 to 23, 2006 for bariatric surgery (gastric bypass surgery). Later, she submitted a bill of Rs 2,23,740 along with supporting documents, but the company repudiated her claim saying it was cosmetic surgery. It said the surgery did not come under the clause; There was no mention of this disease in the exclusion clause of the policy.The family then approached CERS, which wrote to United India but there was no response. CERS and Sharma then issued a notice to Medsave Health Care and United India at the Ahmedabad and Chennai offices.When this too failed to evoke any response, they complained to the Forum on March 26, 2009, alleging deficiency in service and unfair trade practice.They claimed Rs 2,23,740 with 12 per cent interest from the date of the claim till payment and realisation of the claim amount. The complainants also demanded Rs 25,000 as compensation for mental agony and harassment, and Rs 5,000 towards cost, payable to each of the two complainants.United India and Medsave Health Care contested the validity of the statements; the tenability of the complaint under the Consumer Protection Act; the jurisdiction of the Forum; and even disposed of the certificate issued by Dr Mahendra Narvaria as unreliable.When the respondent pleaded for dismissal of the plea, the Forum held that the complainants had established their case well.
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