NATIONAL INSURANCE CO.LTD. Vs. MUKESH BHARGAVA
DELHI STATE CONSUMER DISPUTES REDRESSAL COMMISSION
NATIONAL INSURANCE CO.LTD.
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(1.) CLAIM of the respondent against medi -claim policy for a sum of Rs. 1,00,000 could not be settled by the appellant for want of documents required to be furnished by the
respondent as the appellant doubted the correctness of the statement
given by the respondent at the time of taking the policy as to the
pre -existing disease.
(2.) HOWEVER , vide impugned order dated 31.10.2001, the District Forum has directed the appellant to pay the insured amount of Rs.
1,00,000 along with interest @ 9% and Rs. 1,000 as cost of litigation.
(3.) FEELING aggrieved the appellant has preferred this appeal.
The case of the respondent before the District Forum was that he had a medi -claim policy obtained from the appellant for a sum of Rs.
1,00,000 and the same was valid w.e.f. 27.8.2000 to 26.8.2001. On 15.10.2000 when he was travelling in a train from Madras to Bangalore he felt pain in the chest although he had no previous history of such type
of ailment. He got himself examined in Bangalore at Wockhardt Hospital
and Heart Institute. He remained admitted in the said hospital from
15.10.2000 to 21.10.2000 and he made payment of Rs. 22,995.50. On return to Delhi on 22.10.2000 he was admitted to Malhotra Heart Institute,
Lajpat Nagar, New Delhi for open heart surgery and operation was
performed on 28.10.2000. He remained admitted in the said hospital from
22.10.2000 to 4.11.2000 and he made payment of Rs. 2,02,313 at the said hospital. Respondent filed a claim with the appellant on 22.1.2001 but on
one excuse or the other his claim was not finalised.;
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