LEENA TRIVEDI Vs. ORIENTAL INSURANCE COMPANY LIMITED

JUDGEMENT

(1.) HEARD . By the order impugned the Forum below has dismissed complaint of appellant claiming treatment expenses under a mediclaim policy issued by respondent No. 1 -Insurance Company on 24.12.2003.

(2.) APPELLANT s claim was repudiated by the respondent -company by taking recourse to condition No. 4.1 of the policy which thus reads: "All diseases/injuries which are pre -existing when the cover incepts for the first time. For the purpose of applying this condition, the date of inception of the initial mediclaim policy taken from any of the Indian insurance companies shall be taken, provided the renewals have been continuous and without any break."

(3.) IT is, however, seen that the appellant was insured with the respondent continuously since 17.12.1999. This policy continue to be renewed upto 16.12.2003. However for the subsequent renewal of the policy appellant submitted a cheque of the premium amount to the respondent on 19.12.2003 i.e. with a gap of three days. Strangely this cheque was returned on 23.12.2003 by the respondent -company to the appellant on a rather hyper technical ground that it is not a MICR cheque. On the same day appellant issued a new cheque which was MICR in nature and whereupon a new policy was issued to the appellant on 24.12.2003. There was thus gap of seven days between the previous policy which expired on 16.12.2003 and this new policy issued on 24.12.2003. Conditions of the policy (vide Annexure C -14) filed in evidence contained a clause under title "IMPORTANT" and which thus reads as follows: