NEW INDIA ASSURANCE COMPANY LTD. Vs. HARBANS SINGH

JUDGEMENT

(1.) This revision petition arises out of order passed by the State Commission dismissing the appeal of the petitioner filed against the order of the District Forum allowing the complaint.

(2.) Brief facts of the case relevant to appreciate the case are that the complainant had obtained a Medi-claim policy effective from 11.5.1996 to 10.5.1997. The complainant got admitted in Dayanand Medical College and Hospital on 31.5.1996 after a heart-attack and then moved from there to CMC Hospital. Ludhiana and then to Escorts Heart Institute, Delhi where he underwent a Heart By-pass Surgery. Total expenditure incurred was Rs. 2,17,532.34.

(3.) Upon claim being preferred the Medi-claim policy by the complainant, it was repudiated on 13.2.1998 on the ground that it violates the terms 4.0, 4.1 and 4.2 of the terms of policy and the claim was time-barred. It is in these circumstances that the complainant moved the District Forum who after hearing both the parties allowed the complaint and directed the petitioner to pay Rs. 2 lakh i.e., limit of policy-cover along with interest @ 12% from 12.2.1998 till realisation. On an appeal filed by the petitioner it was also dismissed by the State Commission, hence, this revision petition.