MEREETA JESUDAS Vs. RELIGARE HEALTH INSURANCE COMPANY LTD

JUDGEMENT

(1.) Petitioner, daughter of one late Jesudas Dinseh N Bangera, who was holding a health insurance policy issued by the first respondent company, has filed this writ petition challenging Exhibit P10 award No. 10/KOC/A/HI/0304/2020-2021 dtd. 16/12/2020 passed by the Insurance Ombudsman, Kochi in Complaint No. KOCH-037-2021-0414; whereby the repudiation of the claim of the petitioner by the first respondent Insurance Company is upheld by the Ombudsman.

(2.) Brief material facts for the disposal of the writ petition are as follows:

(3.) The case of the petitioner is that the policy was issued after satisfying that all the policy holders have no pre-existing diseases. Anyhow, Sri.Jesudas died on 10/7/2019 while undergoing treatment due to sudden illness. Thereupon, the petitioner lodged a claim for the reimbursement of the medical expenses and she has submitted all the required documents to the first respondent company. But, the Insurance Company rejected the claim as per letter dtd. 15/11/2019 assigning a reason that 'there is suppression about pre-existing ailment at the time of purchasing the insurance policy'.