Complainant Dharamdas Pritiani was advised by the doctors to undergo treatment upon suffering from a heart ailment in 2008-09. He then underwent a rare treatment called Enhanced External Counter Pulsation (EECP).

The treatment, which was completed in 45 sittings, cost Rs 118,000. However, HDFC Ergo rejected the complainant's claim saying the treatment was experimental and not recognized by the insurer. The insurance company also claimed that a policy holder must be hospitalized for at least 24 hours for reimbursement.

However, the complainant claimed that the treatment was recognized by the United States, and 40 hospitals in India use EECP method to treat heart patients.

The forum said the documents furnished by Pritiani support his claim. Complainant was a heart patient, who underwent a rare and state of the art treatment, which did not require hospitalization, thus he should be reimbursed Rs 118,000, it said.

Consumer redressal forum of India's financial capital Mumbai has directed HDFC Ergo General Insurance Company Ltd to pay Rs 118,000 towards compensation for refuting a policyholder's claim.

The forum has also directed the insurer to pay an additional compensation of Rs 5,000 for mental agony.

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