JAGMOHAN BHATIA Vs. ORIENTAL INSURANCE CO LTD

JUDGEMENT

(1.) Petitioner was the complainant before the District Forum where his complaint was dismissed. An appeal filed before the State Commission was also dismissed.

(2.) Facts leading to filing of this complaint was that the petitioner had a mediclaim policy for the period 8.2.1993-7.2.1994, there was a lapse of seven months after which another policy was issued valid for the period from 15.9.1994 to 14.9.1995. It is during the life of the second policy that the petitioner underwent surgery for 'Benign Prostatic Hyper Trophy.' On a claim being preferred under the policy it was repudiated by the respondent Insurance Company on the ground that this episode falls under the exclusion clause i.e. claims 2.1.13 of the policy which reads as under : 2.1.13 :

(3.) It is in these circumstances, that feeling aggrieved by the repudiation by the respondent, a complaint was filed before the District Forum who after hearing the parties dismissed the complaint. An appeal filed by the petitioner before the State Commission met the same fate, hence the revision petition.