A view of High Court of Karnataka
Turning down an appeal by National Insurance Company, the Karnataka High Court said the insurer cannot adopt an unduly restrictive interpretation of the insurance policy merely because treatment for serious ailment of the insured person can be administered without hospitalisation.The Judge Suraj Govindaraju on September 1 upheld the order of Permanent Lok Adalat, Mangaluru, directing the insurance firm to reimburse the medical expense incurred by 72-year-old retired Vijay Bank officer Padmanabha Shetty G. towards post-chemotherapy injections Zoladex and Xgeva. The Judge said Permanent Lok Adalat has not committed any error of law or jurisdiction, nor has it adopted a view which warrants interference in exercise of the writ jurisdiction of the High Court. The High Court dismissed the writ petition of the insurance firm by imposing cost of ₹50,000.Mr. Shetty, who suffered from Stage IV prostate cancer, had taken medical insurance of National Insurance under the Indian Banks’ Association group scheme. As part of his ongoing cancer treatment, treating oncologists prescribed Zoladex and Xgeva to control tumor growth and protect his bones. Although the insurer reimbursed his inpatient chemotherapy expenses, it repeatedly rejected claims amounting to ₹2,85,470 for these life-sustaining injections. The insurance company contended that the injections were administered without 24-hour hospital admission or general/local anaesthesia and this constituted “outpatient treatment”, which was excluded from coverage of the policy. Published - September 06, 2026 09:45 pm IST
