SUNITA BHALLA Vs. UNITED INIDA INSURANCE CO. LTD.
UNITED INIDA INSURANCE CO. LTD.
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(1.) No one is present for the petitioner when this matter is called. A letter has been sent by Sh. N.K. Bhalla, Advocate who appears to be the husband of the complainant/petitioner, enclosing a copy of the order of the Hon'ble High Court of Punjab and Haryana dated 6.9.2019 and requesting that the matter may be decided on merits in his absence. I have, therefore, considered the record.
(2.) Shri Nirmal Kumar Bhalla husband of the complainant / petitioner obtained a Mediclaim Policy from the respondent for the period from 10.8.2017 to 13.2.2018. The complainant was admitted in a hospital on 11.9.2017 and was treated there, incurring an expenditure of Rs.197660/-. The claim for reimbursement in terms of the Mediclaim Policy taken by him was rejected by the respondent vide letter dated 28.6.2018 which to the extent it is relevant, reads as under:-
"The company shall not be liable to make any payment under this policy in respect of any expenses whatsoever incurred by any Insured person in connection with or in respect of:
4.9 Convalescence, general debility; run-down condition or rest cure, Obesity treatment and its complications including morbid obesity, congenital external disease/defect or anomalies, treatment relating to all psychiatric and psychosomatic disorder, infertility, Sterility, Venereal disease intentional self injury and use of intoxication drugs/alcohol."?
(3.) Being aggrieved, she approached the District Forum by way of a consumer complaint seeking payment of the aforesaid amount with compensation etc.;
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