Squint eye surgery a vision correction treatment, not cosmetic: Court

Surat: The Valsad Consumer Disputes Redressal Commission (CDRC) has ruled that squint eye correction surgery is a vision correction procedure, not a cosmetic treatment, and directed The New India Assurance Company to pay Rs 4.12 lakh in compensation to a resident of Billimora town in Navsari district. The commission described the insurance company's rejection of the mediclaim as unreasonable, noting that the surgery was medically necessary to improve vision rather than for aesthetic purposes. In addition to the claim amount, the insurer has been ordered to pay 8% interest and Rs 3,000 for mental and physical harassment.The complainant had purchased a mediclaim policy with a sum assured of Rs 10 lakh from the company's Billimora branch in Navsari district on March 24, 2024, valid for one year. During the policy period, his daughter underwent right eye divergent squint surgery at a Mumbai hospital in Sept 2024. On Oct 1, 2024, the insurance company rejected the claim, labeling the surgery as cosmetic and citing a policy clause. The parent subsequently challenged this decision at the Valsad CDRC on January 2, 2025.During the hearing, the insurance company argued that the surgery had been performed outside the branch jurisdiction and that squint correction was classified as cosmetic, contending that the claim denial was legally valid. The complainant's advocate countered that the surgery was functional and medically necessary, supported by a detailed doctor's report. The report listed eight reasons why the procedure was essential for her eyesight, including reducing eye strain while reading or using computers, reducing headaches caused by eye misalignment, improving balance and preventing falls on stairs, and enhancing hand-eye coordination. It also noted that the patient had developed a continuous squint one month prior to surgery, confirming that it was not a congenital condition but a medical issue requiring correction.Accepting the doctor's report, the court rejected the insurer's contentions and directed full payment of Rs 4.12 lakh with 8% interest.