JUGAL KISHORE CHOUKESE Vs. ORIENTAL INSURANCE CO LTD

JUDGEMENT

(1.) This Revision Petition is directed against the order passed by the Madhya Pradesh State Consumer Disputes Redressal Commission, Indore in Appeal No. 1647 of 2004 dated 20.1.2006.

(2.) Heard the learned Counsel for the petitioner. The complainant had obtained a medi-claim policy. The wife of the complainant Smt. Sangeeta Choukse was a pregnant. All of a sudden on 4.6.2003 her condition deteriorated. On contacting doctor, the doctor advised her to get admitted in the hospital and accordingly she was admitted in the hospital. Sonography test was done. After the Sonography test, it transpired that the child had already died. She was accordingly treated. On 10.6.2003, she was discharged from the hospital. The complainant preferred a medi-claim before the Insurance Company/respondent.

(3.) The Insurance Company/respondent repudiated the claim. It was claimed by the respondent that the case of treatment of the wife of the petitioner was not covered under the medi-claim policy in terms of Clause 4.12 of the Exclusion Cause which reads as under: "Treatment arising from or traceable to pregnancy (including voluntary termination of pregnancy) and childbirth (including ceasarian section)".