MOHANLAL AGGARWAL Vs. UNITED INDIA INSURANCE CO LIMITED

JUDGEMENT

(1.) In all these petitions, more or less, common questions are involved pertaining to Mediclaim Policy, and therefore, they are being dealt with together by the present common judgment and order.

(2.) The short facts of the case appear to be that the petitioners in all these petitions are persons who were formerly granted Mediclaim Insurance Policies by the respective concerned Insurance Companies. That the respondent-Insurance Companies are subsidiary of General Insurance Corporation of India and there is deep and pervasive control of the Government and they are instrumentality of the State within the meaning of Art. 12 of the Constitution of India.

(3.) So far as the petitioner of S.C.A. No. 11844 of 2002 is concerned, in the year 1992, he got insured for mediclaim for Rs. 40,000/- which as per his say was the maximum coverage permissible at the relevant point of time. Subsequently, the said maximum limit of coverage was raised to Rs. 3,00,000/ - in the year 1993-94, and the petitioner, accordingly, revised the amount of policy, by paying requisite premium. The petitioner, since then, continued to have the insurance of mediclaim by paying premium regularly and even the respondent-Company also continued to renew the policy. The last policy, as per the petitioner, was renewed on October 4, 2001 which was valid upto October 3, 2002 vide Policy No. 181600/48/01/02711 for a sum of Rs. 3,00,000/-. The petitioner requested for renewal of the policy vide his letter dated 9-9-2002 and forwarded an amount of Rs. 6,327/-. However, the petitioner did not get the renewal intimation of the policy, and therefore, the petitioner sent reminder, and thereafter, also sent notice, dated 29-2-2002 through his Advocate. On September 30, 2002 the Insurance Company addressed a letter to the petitioner informing that due to high claim experience the policy will be renewed by 300% premium and the petitioner was requested to send revised premium and the amount of Rs. 18,982/- was also paid by the petitioner by cheque and the receipt, dated 1-10-2002 vide receipt No. 54536 was also issued by the respondent- Insurance Company and the respondent-Insurance Company accepted the aforesaid premium. However, on October 3, 2002 the Insurance Company issued a letter to the petitioner informing that the policy can be renewed only subject to exclusion of five diseases, namely (i) Hyper Tension, (ii) Diabetes Mellitus, (iii) Ischemic Heart Disease, (iv) Nephropathy Hypothyroidism, and (v) Chronic Renal Failure. The petitioner is aged 65 years and it is the case of the petitioner that of late he has become the patient of chronic renal failure and is required to get dialysis four times in a month and is required to take several medicines and also medical supervision, and therefore, he is in need of coverage of mediclaim policy and if the diseases as mentioned above are excluded it would frustrate the mediclaim insurance, and therefore, the present petition.