BINOD PARSAD Vs. M/S NATIONAL INSURANCE COMPANY

JUDGEMENT

(1.) The facts of the case are that the complainant on 23.1.2009 obtained a Mediclaim policy for an insured amount of Rupees three lac for a period of one year i.e. up to 22.1.2010 from the OP Insurance Co. for himself and his two children including Master Vikas Sharma aged 10 years. On 28.6.2010 Vikas fell ill and was admitted in Saroj Hospital and Heart Institute, Madhuban Chowk, Rohini, Delhi with a complaint of severe pain in head and unconsciousness, wherefrom he was discharged on 30.7.2009.

(2.) THE complainant, therefore, filed a complaint before the District Forum with a prayer that he be awarded an amount of Rs.21,076/ - towards the medical bill and Rs.1500/ - towards the purchase of medicines along with interest @ 25% p.a., Rs.10,000/ - towards he compensation and Rs.6,000/ - towards the costs of litigation against the O.P.

(3.) PENDING the complaint, the District Forum called for the indoor patient record of Master Vikas from the concerned hospital and found that since 4 to 5 months Vikas has past history of headache of left side on and off, associated with giddiness and loss of consciousness. As the policy commenced from 23.1.2009, therefore, his illness was within a period of 30 days from the inception of the policy and thus falls within the exclusion clause 4.2 of the policy. The District Forum therefore dismissed the claim of the complainant.