ACHANTA RAMAKRISHNA RAO Vs. NEW INDIA ASSURANCE CO.LTD.
ANDHRA PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION
ACHANTA RAMAKRISHNA RAO
NEW INDIA ASSURANCE CO.LTD.
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P.RAMAKRISHNAM RAJU,PRESIDENT -
(1.) THE unsuccessful
complainant filed this appeal questioning the order made in C.D. No.
19/1997. Since he died pending the appeal, his L.Rs. were brought on record as appellants 2 to 7.
(2.) THE case of the first complainant is that he is a holder of Cancard issued by the second opposite party Bank. The first opposite
party, Insurance Company, jointly with the second opposite party launched
a scheme, Cancomfort, to provide insurance coverage to Cancard holders
and members of their families against personal accident and unanticipated
medical expenses. The complainant subscribed to the said scheme and
obtained Cancomfort Medi Claim Insurance Policy for himself, his wife and
daughter. The period of the policy was from 1.12.1995 to 21.10.1996. The
complainant stated that he is a known diabetic and hypertensive patient
suffering from unstable Angina. He got admitted in Mullapudi Venkata
Ramanamma Memorial Hospital, Tanuku on 4.4.1996 with chest pain and he
was discharged on 10.4.1996. He proceeded to Madras and admitted himself
in the Institute of Cardio Vascular Diseases run by Madras Medical
Mission on 12.4.1996. He underwent Angiogram on 15.4.1996 and also
By -pass surgery on 17.4.1996. He was discharged from the hospital on
30.4.1996. He incurred an expenditure of Rs. 1,88,562.60 ps. As the claim submitted by him was rejected, he filed the complaint.
(3.) THE first opposite party, Insurance Company, in its written version stated that the liability of the insurer is excluded for diseases
which were pre -existing and as the insurer was suffering from Angina
prior to the coverage, he is not entitled to claim any compensation.
The second opposite party merely stated in its written version that contract of insurance is between the complainant and the first
opposite party and as such no deficiency can be attributed to the second
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