UNITED INDIA INSURANCE CO. LTD. Vs. DALBIR SINGH

JUDGEMENT

(1.) This Revision Petition is filed against the order of the State Commission, Punjab.

(2.) The Insurance Co. had issued a policy of medi-claim (Hospitalisation and Domiciliary Hospital Benefit) in favour of the Respondent which was renewed for a sum of Rs. 1,50,000.00 in the joint name of the Respondent and his wife for a period from 20.8.1996 to 19.8.1997 on payment of Annual Premium. The value of the policy was subsequently enhanced in the month of Nov. to Rs. 3.00 lakhs on payment of the additional annual premium and the period of the policy was extended from 28.11.1996 to 22.11.1997.

(3.) The Complainant was admitted to Escort Hospital and spent a sum of Rs. 1,41,720.00 in April, 1997 within the currency of the insurance cover. He lodged a complaint with the Petitioner which was repudiated by the Insurance Co. on the plea that the material fact of his having suffered heart problem was concealed. On a perusal of the proposal form, the State Commission found that there had been no concealment of facts. The State Commission has noticed that in Para 13, clause 4 the Respondent had clearly mentioned that he had undergone bypass surgery in 1987 at Apollo Hospital, Madras. In Para 14 also it has been revealed that the Respondent had undergone bypass surgery. In spite of this disclosure, the insurance cover was issued. The Petitioner had repudiated the claim in spite of these facts. Having issued the insurance policy, the Insurance Co. cannot escape their liability on the plea of non-disclosure. There does not appear to be any infirmity with the orders of the District Forum and the State Commission. We do not find any ground to interfere under clause (b) of Sec. 21 of the CP Act. The Revision Petition is, therefore, dismissed.