ORIENTAL INSURANCE COMPANY LTD. Vs. NARENDRA MEHTA

JUDGEMENT

(1.) Through this writ petition under Articles 226/227 of the Constitution of India, the petitioner insurance company has approached this court for assailing the judgment dated 04.01.2018 passed by the Permanent Lok Adalat, Jodhpur in Case No. 2/2016, whereby, while accepting the application filed by the respondent Mr. Narendra Mehta under Section 22-B of the Legal Services Authorities Act, 1987, whereby the petitioner insurance company was directed to honour the medical reimbursement claim submitted by the respondent against the mediclaim insurance policy.

(2.) Mr. Jagdish Vyas, learned counsel representing the petitioner insurance company, vehemently urged that the respondent was suffering from hypertension and had not completed the waiting period of two years in terms of the condition No. 4.2 of the insurance policy and as such, his claim was rightly repudiated. He, thus, urges this court to exercise its extraordinary/supervisory writ jurisdiction and quash the impugned order as being grossly bad in the eye of law.

(3.) Per contra, Mr. Anil Bhandari, Advocate, representing the respondent, submits that the respondent had taken the mediclaim insurance policy, during currency whereof, he suffered severe Angina pain, whereafter, he was taken to the Surana Hospital and Research Center, Mumbai, and was subject to Coronary Artery Bypass Graft (CABG) surgery. He contends that the cause of CABG surgery was not directly related to hypertension being suffered by the respondent, which is simply a lifestyle disease. He further submits that the claim filed by the respondent was not for the expenses borne for the treatment of hypertension, hence, could not have been repudiated.