ORIENTAL INSURANCE CO LTD Vs. MADHUSUDHAN SHARMA

JUDGEMENT

(1.) Though as many as four complaints against Mediclaim Insurance Policy were decided by the impugned order dated 18.2.2003, the appellant has filed appeal only in respect of Case No.366/2002 as in this case the appellant alone was the opposite party whereas in other cases different companies were opposite parties.

(2.) Vide impugned order the appellant has been directed to pay Rs.51,551 with 9% interest towards mediclaim expenses incurred by the respondent on treatment of Diabetes Mellitious and Hypertension and problem of Asthma and Rs.5,000 as compensation and Rs.500 as cost of litigation.

(3.) The solitary defence raised by the appellant before the District Forum was that the respondent had concealed the factum that she had a long history of Diabetes Mellitious and Hypertension for about 10 years and also problem of Asthama while taking the mediclaim insurance policy and therefore disentitled herself by virtue of exclusion clause of the policy providing that any concealment of material fact would vitiate the policy itself. However, the appellant failed to produce the proposal form.