STAR HEALTH & ALLIED INSURANCE CO. LTD. BRANCH OFFICE,10/124 Vs. HARIDAS C.K. SRIHARI MANATHANATH HOUSE, MUTTUNGAL P.O VADAKARA KOZHIKODE

JUDGEMENT

(1.) This revision petition has been filed by the petitioner against the order dated 29.7.2013 passed by the Kerala State Consumer Disputes Redressal Commission, Thiruvananthapuram (in short, 'the State Commission') in Appeal No. 932/2012 - The Manager, Star Health and Allied Insurance Company Ltd. Vs. Haridas C.K. by which, appeal was dismissed.

(2.) Brief facts of the case are that Complainant/respondent obtained Family Health Optima Insurance Policy from OP/Petitioner for a sum of Rs. 2 lakhs w.e.f. 14.6.2011 and paid premium. Prior to issue of policy complainant and his wife undergone a medical checkup and the result was sent to the opposite party directly. On 10/02/12 the complainant was admitted in Baby Memorial Hospital, Kozhikode with chest pain and undergone angioplasty. He was discharged on 13/02/1 On 15/03/12 he made a claim to the opposite party for the reimbursement of the expenses to a tune of Rs.1,62,522.00 which was rejected on 28/04/12, the reason for rejection is said to be on the basis of exclusion clause in the policy schedule. The complainant contented that there was no such condition while at the time of issuing the policy and receiving the premium. Alleging deficiency on the part of OP, complainant filed complaint before District Forum. OP was proceeded ex-parte before District Forum and learned District Forum allowed complaint and directed OP to reimburse Rs. 1,62,522.00 along with compensation of Rs. 1,000.00. Appeal filed by OP was dismissed by learned State Commission vide impugned order against which, this revision petition has been filed along with application for condonation of delay.

(3.) Heard learned Counsel for the parties finally at admission stage and perused record.