VINOD KUMAR ANEJA (SINCE DECEASED) THROUGH HIS LEGAL HEIRS MS. VEENA ANEJA AND ORS. Vs. NEW INDIA ASSURANCE COMPANY LTD. AND ORS.

JUDGEMENT

(1.) THE prayer in this writ petition is for a mandamus to be issued to Respondent No. 1 New India Assurance Company Ltd. ('NIACL') to reimburse the expenses incurred by the Petitioner towards the treatment of cancer (intravenous chemotherapy) in terms of the mediclaim policy taken by the Petitioner. The second prayer is for a direction to Respondent No. 1 to implement the Awards dated 18th March 2004 and 26th April 2005 of the Insurance Ombudsman by accepting the requisite premium for the period 30th July 2003 to 14th April 2004 on pro rata basis from the Petitioner and process the claim in respect of the medical expenses incurred by him during that period, and pay him the admissible claim amounts.

(2.) THE facts leading to the filing of this petition are that on 30th July 1999 the Petitioner took a mediclaim policy from National Insurance Company Ltd. ('NICL'). This policy was regularly renewed till 29th July 2002. Thereafter, the Petitioner switched over to Respondent No. 1. The policy was to expire on 28th July 2003 and on 10th July 2003 the Petitioner deposited a cheque of Rs. 10,129/ - with Respondent No. 1 for renewal of his mediclaim policy. It may be mentioned that by that time, the Petitioner had lodged the following claims which were all paid by Respondent

(3.) CONSEQUENTLY , on 30th July 2003 and 8th August 2003 the Petitioner filed his claims before the Insurance Ombudsman (Delhi and Rajasthan). On 18th March 2004, the Insurance Ombudsman passed an award 'that the New India Assurance Company Ltd. shall renew the mediclaim policy of the complainant and shall give him all the benefits of continuity as if his policy had been renewed on 30th July 2003 without any break'.