SHASHIKANT AWADOOTH ROTKAR Vs. NATIONAL INSURANCE COMPANY LIMITED

JUDGEMENT

(1.) The present revision petition has been filed against the judgment dated 21.03.2017 of the Maharashtra State Consumer Disputes Redressal Commission, Circuit Bench at Nagpur ('the State Commission') in First Appeal no. 218 of 2014.

(2.) The facts of the case as per the petitioner/complainant are that the petitioner took a Medi-claim Insurance Policy (short MIP) from the respondent/OP nos. 1 and 2 through respondent no. 3 - Mr. Anurag Rathi. The petitioner filed the proposal form which was filled by respondent no. 3. During the operation of the MIP, in January 2011, the petitioner suffered chest pain. He was admitted to the hospital and was referred to Avanti Hospital at Nagpur. The petitioner remained admitted at Avanti Hospital Nagpur from 101.2011 to 17.01.2011 and underwent Angiography and Angioplasty on 13.01.2011 for which the petitioner paid an amount of Rs.1,77,430/-.

(3.) The petitioner and his brother submitted the claim of expenditure for compensation in the MIP with respondent no. 1 on 14.01.2011 and 01.12.2011. However, the respondent nos. 1 and 2 in spite of submitting the entire documents repudiated the medi-claim of the petitioner on 10.02.2012, on the ground of not submitting all the documents. The petitioner, therefore, gave notice on 09.02012 to OP nos. 1 and 2.