ARUN KUMAR Vs. NEW INDIA ASSURANE CO. LTD.

JUDGEMENT

(1.) This revision petition has been filed under section 21(b) of the Consumer Protection Act, 1986, against the impugned order dated 19.07.2012, passed by the Delhi State Consumer Disputes Redressal Commission, (hereinafter referred to as "the State Commission") in Appeal No. A -250/2003, New India Assurance Co. Ltd. & Ors. vs. Arun Kumar, vide which, while allowing the appeal on the ground of suppression of pre -existing disease at the time of obtaining the insurance policy, the order passed by the District Consumer Disputes Redressal Forum on 18.02.2003, allowing the consumer complaint, filed by the present petitioner was set aside.

(2.) The facts of the case are that the petitioner/complainant has been obtaining the medi -claim policy from the respondent, New India Assurance Company since 1997 and he also subscribed to the Good Health Medi -claim Insurance Plan, offered to the holders of Citibank Credit Card. As stated by the complainant, he suffered from degenerative joint disease in both knees, which was first detected and diagnosed on 20.01.2001. The complainant was hospitalised at Sita Ram Bhartiya Institute of Science and Research, New Delhi on 29.04.2001 and discharged on 30.04.2001. He submitted a claim on 16.06.2001 alongwith relevant documents, giving details of the treatment taken at the hospital and submitted a medical bill of Rs. 38,240.50. However, the Insurance Company repudiated his claim vide letter dated 14.08.2001, saying that as per the medical report, he had been suffering from the said disease for the last 4 to 5 years atleast and hence, the claim was not payable. The complainant filed the consumer complaint in question, seeking directions to the Insurance Company to pay him the amount claimed i.e. Rs. 38,240.50 and litigation cost of Rs. 11,000/ - alongwith interest @ 24% per annum till the date of payment of claim.

(3.) The complaint was contested by the respondent, Insurance Company by filing their written submissions before the District Forum, stating that the complaint was not maintainable at Delhi as the Regional Office of the Insurance Company did not have a branch at Delhi. It was also stated that a contract of insurance was one of uberrima fides, that is of utmost good faith and hence, the claimant should have disclosed true condition about his health at the time of filling the proposal form. There was, therefore, no deficiency in service on the part of the respondent.