SUKANTA DAS Vs. NATIONAL INSURANCE CO LTD

JUDGEMENT

(1.) THIS appeal has arisen against the judgment passed by the District Forum, Kolkata Unit -II, on 30.5.2008 in its case No. 34/2007, wherein the Forum below has dismissed the complaint on contest for want of jurisdiction and directed the Complainant to agitate his grievance before the appropriate Legal Forum in accordance with law.

(2.) THE brief facts of the case of the Complainant before the Forum below were that he was a mediclaim policy holder of New India Assurance Company Limited from 1994 -95 to 2001 -02 without any 'Exclusions' (Heart Ailment). The Complainant changed his policy from New India Assurance Company Limited to National Insurance Company Limited in 2002 -03 and it was without any 'Exclusions' (Heart Ailment) and this policy was renewed in 2003 -04 without Exclusions (Heart Ailment) After a few months of renewal the OP issued an 'Endorsement Schedule' on 22.12.2003 by which the OP excluded 'All Heart Ailment' under the policy A/c of the Complainant from inception of policy i.e. 8.9.2002. The Complainant conveyed his strong objection through letter dated 23.2.2004 to the OP's arbitrary decision and pointed out that the policy with them was in continuation of his earlier policy with New India Assurance Company Limited, which was without any 'Exclusions' (Heart Ailment). The NIC made certain queries by issuing a letter dated 8.3 2004 and the Complainant sent reply on 1.4.2004 to the queries as well as further correspondences was made with the OP. The Complainant sent reminders on 5.8.2004, 13.12.2004 and 24.2.2005, but to no effect. Then the Complainant was compelled to approach before the Consumer Association on 10.11.2005, which took up the matter with the OP, but to no effect. The complainant filed the complainant before the District Forum finding no other alternative praying for direction upon the OP to honour the terms and conditions of the contract between him and the NIC in respect of the mediclaim policy of 2002 -03 and let the policies issued in his favour for the year 2006 -07 without Exclusion (Heart Ailment).

(3.) BEING aggrieved by the above -mentioned judgment the Complainant - Appellant has preferred the present appeal contending the same facts as stated by him before the Forum below in the complaint. According to the Appellant the judgment passed by the learned Forum below is erroneous, illegal and liable to be set aside. The Appellant has prayed for allowing the present appeal. The OP took the plea before the Forum below that the policy in question was not without the Exclusion Clause (Heart Ailment). The OP has stated that the mediclaim policy so far issued to the Complainant by them was subject to the terms, conditions and limitations and was not without any Exclusion. The OP called for from the Complainant the xerox copies of the policies when the same was with the New India Assurance Company Limited, but the Complainant motivatedly sent xerox copies of the policies for the years 2000 -01 and 2001 -02 only without sending those for the years from 1994 to 2000. According to the OP the Complainant is liable to be dismissed.