NATIONAL INSURANCE COMPANY LIMITED Vs. SURINDER MOHAN KAIRAM
LAWS(DELCDRC)-2006-3-9
DELHI STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Decided on March 13,2006

NATIONAL INSURANCE COMPANY LIMITED Appellant
VERSUS
Surinder Mohan Kairam Respondents

JUDGEMENT

- (1.) AGAINST mediclaim insurance policy respondent filed a claim of Rs. 1,82,187 with the appellant. The appellant company repudiated the claim on account of concealment of pre -existing disease by the respondent.
(2.) VIDE impugned order dated 25th February, 2000 the District Forum while repelling the repudiation has directed the appellant -company to pay Rs. 1,82,187 towards the actual mediclaim expenses incurred by the respondent and also pay interest @ Rs. 15% and Rs. 1,000 as cost of litigation.
(3.) ADMITTEDLY the insurance policy was taken by the respondent for the period from 8.10.1997 to 7.10.1998 and the respondent was admitted to Escorts Heart Institute and Research Centre (for short EHIRC ) due to severe pain in chest on 28.11.1997. He underwent bypass surgery on 18.12.1997 and was discharged from the hospital on 25.12.1997. According to the respondent the heart problem was detected/diagnosed for the first time when he was admitted in the hospital. The respondent was diagnosed as a case of Ischamic heart disease, unstable angina, triple vessel disease despite the fact that the discharge summary Ex. CW1/4 issued by EHIRC showed that the respondent was normotensive, non -diabetic, non -smoker and had no family history of ischamic heart disease.;


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