The District Consumer Disputes Redressal Commission has directed ManipalCigna Health Insurance to reimburse ₹ 50,700 to a policyholder whose cataract claim it had rejected, holding that the insurer failed to establish that a previous eye condition was linked to the ailment for which the claim was made.
Kaur underwent cataract extraction with intraocular lens implantation in her left eye on December 11, 2025, for an immature cataract. The family submitted a reimbursement claim to the insurer after paying ₹ 50,700 for the treatment. After examining the medical records, the commission found that the earlier treatment did concern the right eye, while the December 2025 surgery involved the left eye.
It said the insurer had not produced medical evidence showing that the earlier PKP or astigmatism was connected to the cataract or affected the treatment.
They argued that the two conditions were unrelated.
The complainants told the commission that the earlier treatment concerned Kaur’s right eye, while the cataract surgery involved her left eye.
