A.K.ANNAMALAI J. - (1.) The opposite party is the appellant.
(2.) The complainant/respondent filed a complaint before the District Forum seeking for the relief of payment of mediclaim amount for Rs.12,266.71 with interest towards medical expenditure incurred for the treatment and Rs.3,000/- as compensation for the sufferings.
(3.) The complainant in his complaint averred that he had mediclaim policy with the opposite party from the year 2000 onwards for himself and for his family and he has paid the premium up to 2003 and in 2003 he had treatment for his hip pain and reported to the Doctor that he was suffering for the same for the past 1 years and as an inpatient he got admitted in the hospital and had treatment from 21.2.03 to 26.2.03 and various tests including MRI scan were taken. After the discharge he has sent his claim form claiming for the expenses to the opposite party and the claim was repudiated by stating that due to pre-existing disease prior to the policy and thereby claim was repudiated. Hence the complainant has come forward with this complaint.;