Consumer Protection Act, 1986; After purchase an overseas travel insurance policy the Petitioner was underwent Coronary Bypass Graft Surgery and thereby spent 12,005 pounds -- Respondent repudiated...
Read MoreConsumer Protection Act, 1986; After purchase an overseas travel insurance policy the Petitioner was underwent Coronary Bypass Graft Surgery and thereby spent 12,005 pounds -- Respondent repudiated the reimbursement and taken plea that the complainant have past medical history of hypercholestremia, Ischaemic Heart Disease as well as hypertension, which were excluded as per the insurance contract -- District Forum directed the Company to pay an amount of Rs.7,19,500/- for medical score with interest @ 9% p.a. from the date of complaint till the date of payment and also to pay Rs.2200/as litigation expenses.” -- State Commission allowed the same on appeal on the ground that complainant had obtained insurance policy by concealing the factum of his previous ailment, namely, hypertension, which has a nexus with the heart problem -- Revision allowed by NCDRC in favour of Claimant with observation that plea of concealment of material fact was not taken by the opposite party in the repudiation letter -- no evidence shown that the petitioner despite of having knowledge of his ailment concealed this fact in proposal form -- having history of hypertension does not lead to conclusion that petitioner was also having previous history of heart problem – heart problem cannot be termed as a claim in respect of a pre existing disease.
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