Bombay High Court: Insurance Company Cannot Reject Mediclaim Reimbursement Merely for Delay in Filing Claim; Must Pay with 6% Interest
Bombay High Court Rules Delayed Mediclaim Claim Cannot Be Rejected Solely on Time Limit
Bombay High Court directs United India Insurance to reimburse health insurance claim with 6% interest, holding restrictive claim filing deadlines void under Section 28 of the Indian Contract Act.
Bombay High Court Gives Relief to Policyholder in Delayed Health Insurance Claim Case
In a significant judgment protecting policyholders, the Bombay High Court has held that an insurance company cannot reject a genuine mediclaim reimbursement merely because the claim was submitted beyond the timeline mentioned in the policy.
The Court directed United India Insurance Company Ltd. to reimburse the insured amount within eight weeks, together with interest at 6% per annum from the date the amount became due and payable.
This ruling is likely to be cited in future insurance disputes where insurers deny claims solely on technical delay grounds.
Case Details
The matter was titled C.P. Ravindranath Menon vs United India Insurance Company Ltd. & Anr., being Writ Petition No. 2474 of 2023 before the Bombay High Court.
The Bench comprised Justice Bharati Dangre and Justice Manjusha Deshpande. The judgment was delivered on 20 April 2026.
Background of the Dispute
The petitioner had availed a Group Health Insurance Policy through his employer, Export Import Bank of India.
Thereafter, reimbursement claims amounting to ₹1,13,487.49 were submitted for medical treatment expenses incurred by himself and his spouse.
The insurance company declined to process the claims on the ground that they had been lodged beyond the prescribed time under the policy conditions.
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United India Insurance argued that the insurance policy was a binding contract and its terms had to be strictly followed. According to the insurer, claims were required to be filed within the stipulated period, and bills older than ninety days were not payable. On that basis, reimbursement was denied.
Legal Issue Before the Court
The central question before the Court was whether an insurance company can extinguish a policyholder’s right to reimbursement merely because the claim was filed after the timeline mentioned in the insurance policy.
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Findings of the Bombay High Court
The Court considered the earlier Supreme Court judgment in The Oriental Insurance Company Ltd. vs Sanjesh & Anr., where restrictive claim-filing timelines were held contrary to Section 28 of the Indian Contract Act, 1872.
Applying the same principle, the Bombay High Court held that a contractual clause which defeats a legitimate claim solely because of lapse of time cannot override statutory law.
The Court observed that where a policyholder is otherwise entitled to reimbursement, the right cannot be denied only because the claim was submitted late. Such restrictive clauses are void to that extent.
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Final Order
Allowing the petition, the Bombay High Court directed United India Insurance Company to reimburse the claim amount within eight weeks.
The Court further ordered payment of interest at the rate of 6% per annum from the date the amount became due and payable.
Why This Judgment Matters
This decision is important because many policyholders face rejection of genuine claims on procedural grounds rather than on the merits of the claim itself.
The judgment makes it clear that technical delay, by itself, cannot automatically defeat a lawful insurance claim. Courts are increasingly examining whether insurers are acting fairly and reasonably rather than merely relying on fine print clauses.
For consumers, this is a strong reminder that a rejected claim is not always the final word.
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Remedy for Rejected Insurance Claims
Where a claim has been denied on delay grounds alone, policyholders may have remedies before the Consumer Commission, Insurance Ombudsman, Civil Courts, or in appropriate circumstances, the High Court.
Each matter depends on the policy wording, reasons for delay, supporting documents, and surrounding facts.
The Law Suits – Insurance Claim Dispute Lawyers in Mumbai
The Law Suits assists clients in matters involving mediclaim rejection, delayed settlements, wrongful repudiation of claims, deficiency in service by insurers, and consumer litigation arising from insurance disputes.
The firm also advises on Insurance Ombudsman complaints, consumer complaints, and higher court remedies where warranted.
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