IRSHAD HUSSAIN,PRESIDENT - (1.) THIS appeal arises out of complaint based on Mediclaim policy.
(2.) FACTS relevant are that, a Mediclaim policy for sum of Rs. 2,00,000 was taken by Sh. Kuldeep Singh on 7.7.1998 from the respondent -Insurance Company. The said insured had filed consumer complaint No. 13 of 2000 before the District Forum, Udham Singh Nagar for award of compensation with the allegations that he went to Amritsar (Punjab) on 25.7.1998 to participate in the marriage ceremony of one of his relatives and there on 29.7.1998, suddenly experienced severe pain in his chest. The next day, on 30.7.1998, he got himself checked up in Ramsaran Das Kishori Lal Charitable Trust Hospital, Amritsar and on complete medical examination, was told by Dr. Harsharan Singh that his kidney had been damaged and that the medical option available to him, was to go for kidney transplant. A donor was arranged and required transplant of kidney was done, in connection of which, he remained admitted in the hospital from 30.7.1998 to 14.10.1998.
(3.) DURING the pendency of the said complaint, insured Sh. Kuldeep Singh expired and his legal representatives, namely, his widow and two minor children, were substituted in the case. This complaint was ultimately dismissed on 14.10.2003 as being premature on account of the fact that the claim with the Insurance Company had not been preferred. It was directed that a proper claim shall be filed within one month, which shall be disposed of by the Insurance Company within a period of four months. The claim having not been paid, fresh consumer complaint No. 102 of 2004 was filed by the legal representatives of the insured on 9.7.2004. The District Forum on an appreciation of the material on record, dismissed the complaint by order dated 26.7.2007, by observing that Sh. Kuldeep Singh was suffering from pre -existing kidney disease and had concealed this fact at the time of purchasing the Mediclaim policy on 7.7.1998. Aggrieved, the legal representatives of the deceased -insured filed this appeal.;